Effects of tranexamic acid for spinal surgery during perioperative period:a systematic review and Meta-analysis
10.3760/cma.j.issn.1001-8050.2017.09.004
- VernacularTitle:氨甲环酸对脊柱手术围术期作用的系统评价和Meta分析
- Author:
Xiang TAN
1
;
Rongbin KUANG
;
Jiyong XIE
;
Bo ZENG
;
Jincen XIE
;
Wendong WEI
;
Huan WANG
;
Xiaojun HU
;
Liang CHEN
;
Changjun PI
Author Information
1. 402460,重庆市荣昌区人民医院骨科
- Keywords:
Tranexamic acid;
Spine;
Blood loss,surgical;
Thromboembolism;
Meta-analysis
- From:
Chinese Journal of Trauma
2017;33(9):785-791
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the effect and safety of tranexamic acid used in spinal surgery by means of a systematic review and Meta-analysis.Methods Literatures were retrieved from Ovid (1999 March to 2017 March),PubMed (1999 March to 2017 March),Sciencedirect(1999 March to 2017 March),CNKI,VIP and Wangfang.All the related literatures were checked on the selection criters.Only the retrospective randomized controlled trails (RCTs) with high quality (Jadad score ≥ 3) and with double-blind process were enrolled.The relevant data were analyzed using RevMan 5.0 to compare about difference of intraoperative and postoperative blood loss,transfusion rate,postoperative activated partial thromboplastin time (APTT),postoperative hematocrit (Hct),postoperative hemoglobin (Hb) and thrombotic complications between tranexamic acid group and placebo group.Results Only 8 high quality RCTs met the inclusion criteria.The use of tranexamic acid in spinal surgery significantly reduced the intraoperative blood loss(SMD =-0.33,95％ CI-0.12,0.54,P ＜0.01),and reduced the rate of transfusion(OR =0.55,95％ CI0.37,0.82,P ＜0.01).TXA group had a significant decrease of APTT at 24 h after surgery(MD =1.45,95％ CI-2.92,0.01,P ＞ 0.05),a significant increase of postoperative Hct (MD =1.55,95％ CI 0.45,2.65,P ＜ 0.01) and an enhancement of Hb (MD =0.49,95％ CI 0.20,2.65,P ＜ 0.01) compared with placebo group.The difference of thrombotic complication rates risks between tranexamic acid group and placebo group was not statistically significant(OR =1.01,95％ CI 0.06,16.52,P ＞ 0.05).Conclusion The use of tranexamic acid can significantly reduce intraoperative blood loss and the rate of transfusion during spinal surgery,without increase of postoperative deep vein thrombosis or pulmonary embolism.
