Efficacy of tranexamic acid in reducing perioperative blood loss in craniomaxillofacial plastic and cosmetic surgery: a systematic review and meta-regression analysis
10.13303/j.cjbt.issn.1004-549x.2025.12.019
- VernacularTitle:基于Meta回归分析系统评价氨甲环酸降低颅颌面整形外科患者围手术期失血的临床效果
- Author:
Hongmei MA
1
;
Chenxi LI
2
;
Yao LIU
3
;
Jingfei HAN
4
;
Jiaojun ZHAO
5
;
Mingchao DING
6
;
Jialin SUN
7
Author Information
1. Intensive Care Unit (ICU), People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
2. Department of Oral and Maxillofacial Oncology & Surgery, School/Hospital of Stomatology, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
3. Division of Blood Transfusion, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
4. Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
5. Division of Aesthetic and Plastic Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
6. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
7. School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Publication Type:Journal Article
- Keywords:
craniomaxillofacial surgery;
plastic and cosmetic surgery;
tranexamic acid;
perioperative blood loss
- From:
Chinese Journal of Blood Transfusion
2025;38(12):1770-1778
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To comprehensively evaluate the clinical efficacy of a single dose of tranexamic acid (TXA) in reducing perioperative blood loss in patients undergoing craniomaxillofacial plastic and cosmetic surgery through meta-regression analysis. Methods: Embase, PubMed, Wanfang Data, VIP database, China National Knowledge Infrastructure (CNKI), the Chinese Clinical Trial Registry (ChiCTR) and Cochrane Central Register of Controlled Trials (CENTRAL) were electronically retrieved to collect clinical studies evaluating efficacy of perioperative TXA administration in patients undergoing craniomaxillofacial plastic and cosmetic surgery, from inception to August 2024. Quality assessment of randomized controlled trials (RCTs) was performed using Cochrane Collaboration's Risk of Bias Tool. Based on the results of methodological heterogeneity, corresponding meta-analyses were conducted using either random-effects or fixed-effects models in R programming software. Results: Thirty-one articles were included, involving 2 072 patients who underwent craniomaxillofacial plastic and cosmetic surgeries. Among these patients, 1 051 were in the TXA treatment group, and 1 021 were in the control group. The paired meta-analysis showed that compared with the control group, the use of TXA significantly reduced bleeding volume in perioperative patients [standardized mean difference (SMD)=-1.13; 95%CI (-1.47, -0.80), P<0.001]. Subgroup analysis revealed that TXA significantly reduced intraoperative bleeding volume in patients across different surgeries, with the order of efficacy as follows: orthognathic surgery [SMD=-1.44; 95%CI (-2.07, -0.80), P<0.001], cleft palate repair [SMD=-1.32; 95%CI (-2.14, -0.50), P<0.001], rhinoplasty [SMD=-0.97; 95%CI (-1.63, -0.30), P<0.001], and craniosynostosis [SMD=-0.96; 95%CI (-1.40, -0.53), P=0.040]. The result of the meta regression showed there was no significant difference in the hemostatic effect of TXA on patients with increasing doses (5, 10, 15, 20, 25 mg/kg) (P=0.650). Sensitivity analysis verified that the pooled values were stable and reliable. The Egger's test indicated a certain degree of publication bias (Z=-3.40, P<0.001). Conclusion: Existing evidence suggests that TXA effectively reduces perioperative blood loss in patients undergoing craniofacial plastic surgery, regardless of its dosage administered.
