氨甲环酸预防剖宫产术中术后出血的Meta分析  

Preventive effect of tranexamic acid for intraoperative and postoperative bleeding of cesarean section: a meta analysis

作　　者：孙美果[1] 尹宗智[1] 

机构地区：[1]安徽医科大学第一附属医院妇产科,安徽合肥230032

出　　处：《中国妇幼保健》2016年第9期1994-1999,共6页Maternal and Child Health Care of China

基　　金：国家自然科学青年基金编号(81300514);安徽省重点科研项目编号(12070403064)

摘　　要：目的探讨使用氨甲环酸预防剖宫产术中术后出血的有效性及安全性。方法检索万方、中国知网(CNKI)和Pub Med数据库,共检索出224篇文献,按统一标准筛选,最终纳入14项随机对照试验研究,使用Stata 11.0软件进行Meta分析。结果此次研究共纳入氨甲环酸处理组1 383人,对照组1 392人。Meta分析结果显示:与对照组相比,使用氨甲环酸可显著降低剖宫产手术总出血量(WMD=-156.3,95%CI=-204.2^-108.4,P<0.001)、术中出血量(WMD=-127.1,95%CI=-180.6^-73.6,P<0.001)及术后2 h出血量(WMD=-47.1,95%CI=-64.3^-30.0,P<0.001)。按氨甲环酸剂量(1 g或10 mg/kg)和种族进行亚组分析后,差异仍具有统计学意义(P<0.05)。结论氨甲环酸处理可明显降低剖宫产手术术中及术后出血量。Objective To explore the effectiveness and safety of tranexamic acid in prevention of intraoperative and postoperative bleeding of cesarean section. Methods A total of 224 literatures were searched out from Wanfang,CNKI,and Pub Med Databases,then the literatures were screened according to a uniform standard,14 random case-control studies were included into the study finally,meta analysis was performed by Stata 11. 0 software. Results A total of 1 383 cases in tranexamic acid group and 1 392 cases in control group were included into the study. Meta analysis showed that compared with control group,tranexamic acid treatment significantly reduced the total amount of bleeding（ WMD =-156. 3,95% CI =- 204. 2-- 108. 4,P〈0. 001）,the amount of intraoperative bleeding（ WMD =- 127. 1,95% CI =-180. 6--73. 6,P〈0. 001）,and the amount of bleeding after two hours of operation（ WMD =- 47. 1,95% CI =- 64. 3-- 30. 0,P〈0. 001）. There were statistically significant differences among different tranexamic acid dose groups（ 1 g or 10 mg / kg） and races（ P〈0. 05）. Conclusion Tranexamic acid treatment can significantly reduce intraoperative and postoperative bleeding amounts of cesarean section.

关 键 词：氨甲环酸 剖宫产出血 META分析 

分 类 号：R713[医药卫生—妇产科学]