【摘要】 目的系统评价短节段后路腰椎融合术中静脉使用氨甲环酸的疗效及安全性。方法以"氨甲环酸"+"腰椎融合"为关键词,计算机检索PubMed、Embase、Medline、Cochrane Library、CNKI、CBM、VIP、Wanfang Data等数据库自建库至2020年12月的随机对照试验。实验组为静滴氨甲环酸,对照组为静滴生理盐水,比较两组总失血量、术中出血量、术后引流量、输血率及深静脉血栓事件发生率,采用RevMan 5.3软件进行meta分析。结果共纳入6篇文献,共包含557例患者,meta分析结果显示,实验组总失血量(MD=-280.88,95%CI:-309.18,-252.59,P <0.000 01),术中出血量(MD=-73.34,95%CI:-128.52,-18.15,P=0.009),术后引流量(MD=-150.29,95%CI:-211.48,-89.10,P <0.000 01),输血率(OR=0.32,95%CI:0.19,0.52,P <0.000 01)均低于对照组。两组深静脉血栓事件发生率比较,差异无统计学意义(P> 0.05)。结论短节段后路腰椎融合术中静脉使用氨甲环酸疗效明确,安全可靠,但需更多高质量的随机对照试验进一步证实。更多还原

【Abstract】 Objective To systematically evaluate the efficacy and safety of intravenous Tranexamic Acid in short-segment posterior lumbar interbody fusion. Methods Randomized controlled trial from PubMed, Embase, Medline,Cochrane Library, CNKI, CBM, VIP, Wanfang and other self-built databases up to December 2020 were searched using the keywords “trantranic acid” and “lumbar fusion”. The experimental group was intravenous Tranexamic Acid, and the control group was intravenous normal saline. Total blood loss, intraoperative blood loss, postoperative drainage, blood transfusion rate and incidence of deep venous thrombosis events were compared between the two groups. Meta-analysis was performed using RevMan 5.3 software. Results A total of six literatures were included, including 557 patients.Meta-analysis results showed that total blood loss(MD =-280.88, 95%CI:-309.18,-252.59, P < 0.000 01), intraoperative blood loss(MD =-73.34, 95%CI:-128.52,-18.15, P = 0.009), postoperative drainage volume(MD =-150.29,95%CI:-211.48,-89.10, P < 0.000 01), transfusion rate(OR = 0.32, 95%CI: 0.19, 0.52, P < 0.000 01) in the experimental group were lower than the control group. There was no significant difference in the incidence of deep vein thrombosis events between the two groups(P > 0.05).Conclusion Intravenous Tranexamic Acid is effective and safe in short-segment posterior lumbar interbody fusion, but it needs more high-quality randomized controlled trial to confirm.更多还原