發(fā)布時間：2018-04-22 21:26

  本文選題：局部 + 關(guān)節(jié)腔��； 參考：《中國矯形外科雜志》2017年15期

【摘要】：[目的]用Meta分析的方法探討局部與靜脈應(yīng)用氨甲環(huán)酸(tranexamic acid,TXA)對全髖關(guān)節(jié)置換術(shù)(total hip arthroplasty,THA)的安全性及有效性。[方法]計算機(jī)檢索Pub Med、EBSCO、The Cochrane Library數(shù)據(jù)庫、中國知網(wǎng)、萬方數(shù)據(jù)庫,檢索內(nèi)容為關(guān)于局部應(yīng)用TXA減少THA出血量的臨床隨機(jī)對照試驗(yàn)(randomized controlled trial,RCT)和半隨機(jī)對照試驗(yàn)(q RCT),檢索時限為1999年1月~2016年6月。按納入、排除標(biāo)準(zhǔn)進(jìn)行文獻(xiàn)篩選和質(zhì)量評估,應(yīng)用Rev Man 5.2軟件進(jìn)行Meta分析。[結(jié)果]納入8篇文獻(xiàn),2 144例患者,局部應(yīng)用氨甲環(huán)酸組789例,靜脈組1 355例。Meta分析結(jié)果顯示:(1)安全性:局部組與靜脈組相比,術(shù)后深靜脈血栓(DVT)發(fā)生率[RR=0.76,95%CI(0.22,2.59),P=0.66]、肺栓塞(PE)發(fā)生率[RR=0.73,95%CI(0.08,7.02),P=0.79]、切口感染率[RR=1.26,95%CI(0.54,2.93),P=0.59]差異均無統(tǒng)計學(xué)意義;(2)有效性:局部組與靜脈組對比,術(shù)后總失血量[WMD=16.75,95%CI(-30.07,63.57),P=0.48]、血紅蛋白下降值[WMD=0.30,95%CI(0.02,0.58),P=0.03]、輸血率[RR=1.37,95%CI(0.97,1.93),P=0.07]差異均無統(tǒng)計學(xué)意義。[結(jié)論]初次單側(cè)全髖關(guān)節(jié)置換術(shù)局部應(yīng)用氨甲環(huán)酸與靜脈應(yīng)用相比具有相當(dāng)?shù)陌踩院陀行浴?br/>[Abstract]:[objective] to investigate the safety and efficacy of local and intravenous application of tranexamic acid (TXA) in total hip arthroplasty for total hip arthroplasty (THAs). [methods] the Cochrane Library database was searched by computer in Pub Medsite. The contents of the search were randomized controlled trialoma (RCTT) and semi-randomized control trial (QRCTs), which were used to reduce the amount of THA bleeding. The search time was from January 1999 to June 2016. Literature screening and quality evaluation were carried out according to inclusion and exclusion criteria, and Meta analysis was carried out with Rev Man 5.2 software. [results] A total of 2 144 patients were included in 8 literatures, 789 patients were treated locally with carbamate, and 1 355 patients were given intravenous administration. The results of Meta-analysis showed that the safety of the local group was higher than that of the venous group. The incidence of DVT was 0.22 / 2.59 P0.66, the incidence of PE was 0.087.02 / 0.79, and the rate of incision infection [RRN1.2695CI0.542.93CI0.542.93C / P0.59] was not statistically significant (P 0.59): the local group was compared with the intravenous group, and there was no significant difference between the local group and the venous group. The total blood loss [WMD-16.75-95CI-30.07], hemoglobin decreased [WMD-0.30 ~ 95CIQ 0.03], and the blood transfusion rate [RRN1.3795 CI 0.971.93P0.07] had no statistical significance. [conclusion] the primary unilateral total hip replacement is safe and effective compared with intravenous application.
【作者單位】： 濱州醫(yī)學(xué)院附屬醫(yī)院骨關(guān)節(jié)外科;
【基金】：山東省自然科學(xué)基金(編號:ZR2015PH006)
【分類號】：R687.4

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本文編號：1789025