A meta-analysis of randomized controlled trials
A meta-analysis of randomized controlled trials
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发表时间：
2019
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通讯作者：
Ning Wang;Xiaojiang Xiong;Lixin Xu;Ming Ji;Tao Yang;Jin Tang;Yong Yang;Wangwei Liu;
中科院分区：
文献类型：
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作者：
Ning Wang;Xiaojiang Xiong;Lixin Xu;Ming Ji;Tao Yang;Jin Tang;Yong Yang;Wangwei Liu;
背景资料：本研究的目的是评估初次全髋关节置换术（THA）中口服和静脉注射氨甲环酸（TXA）的成本效益和输血。研究方法：对PubMed、Embase、Web of Science和科克伦图书馆进行了系统检索，以查找比较口服和IV TXA用于初次THA的随机对照试验（RCT）。主要结果是总失血量、最大血红蛋白下降、输血需求和成本效益。次要结局为住院时间、深静脉血栓形成（DVT）和/或肺栓塞（PE）。结果：纳入了4项独立的RCT，涉及391例患者。两组之间的总失血量（P = 0.99）、最大血红蛋白下降（P = 0.73）和住院时间（P = 0.95）无差异。输血要求（P = 0.97）相似。总平均费用口服组为75.41美元，静脉注射组为580.83美元。两组之间DVT（P =.3）的发生率无显著差异，所有研究均未报告PE。结论：口服TXA在减少初次THA的总失血量、最大血红蛋白下降和输血需求方面显示出与IV TXA相似的疗效和安全性。然而，口服TXA可能比IV TXA更具成本效益。证据等级：I级，治疗性研究。缩略语：CI =置信区间，DVT =深静脉血栓形成，IV =静脉内，MD =平均差，PE =肺栓塞，RCT =随机对照试验，TKA =全膝关节置换术，TXA =氨甲环酸。
Background: The purpose of this study was to assess the cost benefit and transfusions of oral and IV tranexamic acid (TXA) in primary total hip arthroplasty (THA). Methods: PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for randomized controlled trials (RCTs) comparing oral and IV TXA in primary THA. Primary outcomes were total blood loss, maximum hemoglobin drop, transfusion requirements, and cost benefit. Secondary outcomes were length of stay, deep venous thrombosis (DVT) and/or pulmonary embolism (PE). Results: Four independent RCTs were included involving 391 patients. There was no difference in the total blood loss (P= .99), maximum hemoglobin drop (P= .73), and the length of stay (P= .95) between the 2 groups. Transfusion requirements (P= .97) were similar. The total mean cost was the US $75.41 in oral TXA group and the US $580.83 in IV TXA group. The incidence of DVT (P= .3) did not differ significantly between the 2 groups, and no PE was reported in all studies. Conclusion: Oral TXA shows similar efficacy and safety as IV TXA in reducing total blood loss, maximum hemoglobin drop and transfusion requirements in primary THA. However, oral TXA may be more cost-benefit than IV TXA. Level of Evidence: Level I, therapeutic study. Abbreviations: CI = confidence interval, DVT = deep vein thrombosis, IV = intravenous, MD =mean difference, PE = pulmonary embolisms, RCTs = randomized controlled trials, TKA = total knee arthroplasty, TXA = tranexamic acid.