【摘要】：目的:目的通過Meta分析對比關節(jié)腔注射和靜脈注射氨甲環(huán)酸(TXA)對減少全膝關節(jié)置換(TKA)術后出血作用的有效性及安全性差異。方法:通過計算機檢索Cochrane Library、Embase、Pubmed英文數(shù)據(jù)庫以及萬方數(shù)據(jù)庫,中國知網(wǎng)中文數(shù)據(jù)庫中2015年1月到2016年6月所有關于關節(jié)腔注射和靜脈注射TXA治療全膝關節(jié)置換術術后出血的臨床隨機對照試驗(RCTs),根據(jù)Jadad評分量表對納入的文獻進行評分,使用Revman 5.2軟件進行Meta分析。結果:結果共納入6篇文獻,納入患者578例,其中局部應用關節(jié)腔注射TXA288例,靜脈注射TXA 290例。關節(jié)腔注射與靜脈注射TXA在術前血紅蛋[MD=0.08,95C l%(-0.09,0.24)P=0.36]、術后血紅蛋白量[MD=0.10,Cl95%(-0.12,0.31)P=0.38],術前紅細胞壓積量[MD=-0.34,Cl95%(-1.23,0.54)P=0.45],術后紅細胞壓積[M D=-0.09,Cl95%(-2.07,1.90)P=0.93],總失血[MD=0.93,Cl95%(0.21,4.16)P=0.92]術后輸血率[MD=-0.45,Cl95%(-1.20,0.29)P=0.23],住院天數(shù)[MD=1.50,Cl95%(0.62,3.66)P=0.37]及血栓事件的發(fā)生[MD=1.50,Cl95%(0.62,3.66)P=0.37]方面差異均無統(tǒng)計學意義。結論:結論是關節(jié)腔內(nèi)注射與靜脈注射氨甲環(huán)酸在減少全膝關節(jié)置換手術術后出血的有效性和安全性并無差異,兩種給藥方式均可以減少TKA術后出血且兩種給藥途徑在深靜脈血栓和肺栓塞發(fā)生率上并沒有明顯區(qū)別。
[Abstract]:Aim: to compare the efficacy and safety of intra-articular injection and intravenous injection of (TXA) in reducing bleeding after total knee arthroplasty (TKA) by Meta analysis. Methods: Cochrane Library,Embase,Pubmed English database and Wanfang database were searched by computer. All clinical randomized controlled trials (RCTs),) between January 2015 and June 2016 in Chinese database of Chinese knowledge website for the treatment of bleeding after total knee arthroplasty with intra-articular injection and intravenous injection of TXA According to the Jadad rating scale, the included literature was graded and Meta analysis was carried out with Revman 5.2 software. Results: a total of 6 articles were included, including 578 patients, including local injection of TXA288 in articular cavity and intravenous injection of TXA in 290cases. Preoperative heme [MD=0.08,95C 1% (- 0. 09, 0. 24) P < 0. 36] and postoperative heme volume [MD=0.10,Cl95% (- 0. 12, 0. 31) p = 0. 38] by intra-articular injection and intravenous injection of TXA. Preoperative hematocrit [MD=-0.34,Cl95% (- 1.23,0.54) P0. 45], postoperative hematocrit [MD=- 0.09, Cl 95% (- 2.07, 1.90) P0. 93], total blood loss [MD=0.93,] Cl95% (0.21, 4.16) P = 0.92] postoperative blood transfusion rate [MD=-0.45,Cl95% (- 1.20, 0.29) P = 0.23], length of hospital stay [MD=1.50,Cl95% (0.62, 3.66) P = 0.37] and occurrence of thrombus events [MD=1.50,] There was no significant difference in Cl95% (0.62, 3.66) P = 0.37. Conclusion: there is no difference in efficacy and safety between intra-articular injection and intravenous injection of carbacycloic acid in reducing postoperative bleeding after total knee arthroplasty. Both methods of administration could reduce bleeding after TKA and there was no significant difference in the incidence of deep venous thrombosis and pulmonary embolism between the two routes.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

【參考文獻】

相關期刊論文 前9條

1 高福強;孫偉;郭萬首;李子榮;;局部應用氨甲環(huán)酸減少全膝關節(jié)置換術后失血量的系統(tǒng)評價[J];中國骨與關節(jié)損傷雜志;2014年08期

2 彭慧明;翁習生;翟吉良;林進;金今;錢文偉;趙麗娟;;全膝關節(jié)置換術圍手術期異體輸血率及其影響因素[J];協(xié)和醫(yī)學雜志;2014年02期

3 張延杰;郝軍;高文香;;不同劑量氨甲環(huán)酸對全膝關節(jié)置換術后失血量的影響[J];山東醫(yī)藥;2013年19期

4 張瑜哲;金毅;蘇禮;鄭稼;;氨甲環(huán)酸減少初次單側全膝關節(jié)置換術后失血量的臨床研究[J];中國矯形外科雜志;2013年08期

5 姚建華;孫天勝;李海鵬;黃炎;朱兵;吳軍;;人工全膝關節(jié)置換術后自體引流血回輸?shù)呐R床效果[J];中國輸血雜志;2012年03期

6 何濤;曹力;楊德盛;阿德力;胥伯勇;李國慶;陳虎;曾峗;;全膝關節(jié)置換術中使用止血帶療效與安全性的meta分析[J];中華外科雜志;2011年06期

7 羅吉偉;金大地;黃美賢;廖華;徐達傳;;全膝關節(jié)置換術圍手術期失血量的評估[J];南方醫(yī)科大學學報;2006年11期

8 康焱;傅明;盛璞義;何愛珊;楊忠漢;楊子波;徐棟梁;廖威明;;人工全膝關節(jié)置換術后傷口周圍瘀斑形成的危險因素分析[J];中華創(chuàng)傷骨科雜志;2010年12期

9 張陽;錢齊榮;吳海山;李曉華;吳宇黎;祝云利;趙輝;;氨甲環(huán)酸減少全膝關節(jié)置換術失血量的Meta分析[J];中華骨科雜志;2009年06期

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