Efficacy and safety of tranexamic acid in patients undergoing surgery for bone and soft tissue tumors: a propensity score matching analysis
Efficacy and safety of tranexamic acid in patients undergoing surgery for bone and soft tissue tumors: a propensity score matching analysis
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DOI：
10.1093/jjco/hyac078
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发表时间：
2022-05-09
影响因子：
2.4
通讯作者：
Nakashima，Yasuharu
中科院分区：
文献类型：
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作者：
Oyama，Ryunosuke;Setsu，Nokitaka;Nakashima，Yasuharu
目的 探讨氨甲环酸在骨与软组织肿瘤手术患者中的疗效和安全性。方法回顾性收集2017年1月至2018年12月期间连续接受开放活检、边缘切除、刮宫或广泛切除的454例骨与软组织肿瘤患者的数据，对接受氨甲环酸治疗的患者与未接受氨甲环酸治疗的患者进行倾向评分匹配。主要结局变量是术中、围手术期和估计失血量（分别为 IBL、PBL 和 EBL）。 结果根据患者是否接受氨甲环酸来定义氨甲环酸 (+) 和氨甲环酸 (-) 组。 454例患者中，开放活检102例，边缘切除175例，刮宫54例，广泛切除123例。边缘切除和广泛切除中氨甲环酸（+）组术中失血量均显着低于氨甲环酸（-）组（边缘切除分别为17.3 g和70.3 g，P= 0.045；广泛切除：分别为 128.8 与 273.1 g，P= 0.023）。广泛切除的氨甲环酸 (+) 组的围手术期失血量和估计失血量也显着较低（围手术期失血量：分别为 341.5 与 686.5 g，P= 0.0039；估计失血量：分别为 320.7 与 550.6 ml，P= 0.030）。两组均未发生静脉血栓栓塞。结论本研究表明，TXA 给药安全有效地减少失血，特别是对于广泛切除术，且不良事件发生率没有增加。
ObjectiveThe aim of this study was to investigate the efficacy and safety of tranexamic acid in patients undergoing surgery for bone and soft tissue tumors.MethodsData were retrospectively collected from 454 consecutive patients with bone and soft tissue tumors who underwent open biopsy, marginal resection, curettage or wide resection between January 2017 and December 2018. We performed propensity score matching of patients who received tranexamic acid with those who did not. The primary outcome variables were intra-operative, peri-operative and estimated blood loss (IBL, PBL and EBL, respectively).ResultsTranexamic acid (+) and tranexamic acid (−) groups were defined according to whether patients received tranexamic acid or not. Among the 454 patients, open biopsy was performed in 102, marginal resection in 175, curettage in 54 and wide resection in 123. Intra-operative blood loss was significantly lower in the tranexamic acid (+) group than in the tranexamic acid (−) group for both marginal and wide resection (marginal resection: 17.3 vs. 70.3 g, respectively,P= 0.045; wide resection: 128.8 vs. 273.1 g, respectively,P= 0.023). Peri-operative blood loss and estimated blood loss were also significantly lower in the tranexamic acid (+) group for wide resection (peri-operative blood loss: 341.5 vs. 686.5 g, respectively,P= 0.0039; estimated blood loss: 320.7 vs. 550.6 ml, respectively,P= 0.030). No venous thromboembolism occurred in either group.ConclusionThis study suggests that TXA administration safely and effectively reduces blood loss, in particular for wide resection, with no increase in the rate of adverse events.