Efficacy and safety of tranexamic acid application in total hip arthroplasty:a meta-analysis
10.3969/j.issn.2095-4344.2014.35.022
- VernacularTitle:氨甲环酸用于全髋关节置换有效性与安全性的Meta分析
- Author:
Binggen LIU
;
Qingjiang PANG
- Publication Type:Journal Article
- Keywords:
arthroplasty,replacement,hip;
tranexamic acid;
blood loss,surgical;
meta-analysis
- From:
Chinese Journal of Tissue Engineering Research
2014;(35):5699-5706
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Whether tranexamic acid can effectively and safely reduce blood loss and al ogeneic transfusion rate in total hip arthroplasty remains controversial at present. OBJECTIVE:To assess the efficacy and safety of tranexamic acid administration in total hip arthroplasty using meta-analysis. METHODS:Clinical randomized control ed trials concerning tranexamic acid application in total hip arthroplasty published from January 1969 to December 2013 were retrieved from the PubMed, Ovid, Elsevier, Cochrane library, China National Knowledge Infrastructure and Wanfang database. Intraoperative blood loss, postoperative blood loss, total blood loss, al ogeneic transfusion rate and incidence of venous thromboembolism were compared using meta-analysis between the tranexamic acid and control groups. Detection and literature references were used as supplementary data. RevMan 5.0 software provided by Cochrane col aboration was used for meta-analyses. Conclusion was obtained according to analysis. The analysis checked the heterogeneity of data. RESULTS AND CONCLUSION:After comprehensive and rigorous screening, 19 high-quality (Jadad score not less than 3) randomized control ed studies were included. Meta-analysis results demonstrated that compared with the control group, tranexamic acid decreased the total blood loss [weighted mean difference (WMD)=-341.04, 95%confidence interval (CI) (-508.10,-173.97), P<0.001], intraoperative blood loss [WMD=-63.26, 95%CI (-111.33,-15.18), P=0.01] and postoperative blood loss [WMD=-229.53, 95%CI (-338.11,-120.94), P<0.000 1], and diminished al ogeneic transfusion rate [relative risk=0.45, 95%CI (0.35, 0.57), P<0.000 1] in patients undergoing total hip arthroplasty. No significant difference in incidence of venous thromboembolism was detectable. These data suggested that tranexamic acid could reduce blood loss and transfusion rate in patients undergoing total hip arthroplasty without increasing the risk of incidence of venous thromboembolism.
