关节镜下肩袖修复术使用氨甲环酸有效性与安全性的Meta分析  

Clinical effectiveness and safety of tranexamic acid in arthroscopic rotator cuff repair:a meta-analysis

作　　者：张慧伟[1] 刘凯[2] ZHANG Huiwei;LIU Kai(Department of Anaesthesia,People’s Hosipital of Leshan,Leshan,Sichuan 614000,P.R.China;Department of Joint Surgery,People’s Hosipital of Leshan,Leshan,Sichuan 614000,P.R.China)

机构地区：[1]乐山市人民医院麻醉科,四川乐山614000 [2]乐山市人民医院关节外科,四川乐山614000

出　　处：《华西医学》2024年第10期1551-1556,共6页West China Medical Journal

摘　　要：目的对关节镜下肩袖修复术使用氨甲环酸的临床疗效与安全性进行Meta分析。方法检索Cochrane图书馆、PubMed、Embase、维普中文科技期刊数据库、中国知网、万方数据库,检索时间跨度为建库至2024年8月,收集所有关节镜下肩袖修复术围手术期使用氨甲环酸的随机对照试验,采用均数差(mean difference,MD)及危险差(risk difference,RD)进行分析。结局指标为术中视野、手术时长、平均动脉压、凝血相关并发症发生率。采用RevMan 5.3软件进行Meta分析。结果共纳入7篇随机对照试验。Meta分析结果显示:使用氨甲环酸组术中视野清晰度评分优于未使用氨甲环酸组[MD=9.10分,95%置信区间(confidence interval,CI)(4.05,14.15)分,P=0.0004],手术时长短于未使用氨甲环酸组[MD=-12.07 min,95%CI(-17.21,-6.93)min,P<0.00001];两组在平均动脉压[MD=-1.08 mm Hg(1 mm Hg=0.133 kPa),95%CI(-3.13,0.98)mm Hg,P=0.30]和凝血相关并发症发生率[RD=0.02,95%CI(-0.01,0.06),P=0.22]方面差异无统计学意义。结论对于肩关节镜修复肩袖损伤患者,使用氨甲环酸可改善视野,减少手术时间,且不增加凝血相关并发症发生率。Objective To evaluate the clinical effectiveness and safety of tranexamic acid(TXA)in arthroscopic rotator cuff repair by meta-analysis.Methods Randomized controlled trials evaluating the clinical effectiveness and safety of TXA use in the perioperative period of arthroscopic rotator cuff repair were identified from the Cochrane Library,PubMed,Embase,VIP Chinese Science and Technology Periodical Database,Chinese National Knowledge Infrastructure,and Wanfang database,with a search time span from the inception of the database to August 2024.Metaanalysis was conducted using RevMan 5.3 software,and mean difference(MD)and risk difference(RD)were used as measures of effect size.Results A total of 7 randomized controlled trials were included.Meta-analysis demonstrated significant differences in good visual clarity[MD=9.10,95%confidence interval(CI)(4.05,14.15),P=0.0004]and operative time[MD=−12.07 min,95%CI(−17.21,−6.93)min,P<0.00001].There was no significant difference in mean arterial pressure[MD=−1.08 mm Hg(1 mm Hg=0.133 kPa),95%CI(−3.13,0.98)mm Hg,P=0.30]or adverse event rate[RD=0.02,95%CI(−0.01,0.06),P=0.22]between the two groups.Conclusion TXA is effective and safe in enhancing visual clarity and significantly reducing operative time in arthroscopic rotator cuff repair,without increasing the incidence of adverse events.

关 键 词：氨甲环酸 肩关节镜 肩袖修复 

分 类 号：R687.4[医药卫生—骨科学]