Effect of Topical Tranexamic Acid on Bleeding and Quality of Surgical Field during Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis: A Triple Blind Randomized Clinical Trial
Effect of Topical Tranexamic Acid on Bleeding and Quality of Surgical Field during Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis: A Triple Blind Randomized Clinical Trial
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DOI：
10.1371/journal.pone.0104477
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发表时间：
2014-08-18
期刊：
影响因子：
3.7
通讯作者：
Poorolajal, Jalal
中科院分区：
文献类型：
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作者：
Jahanshahi, Javaneh;Hashemian, Farnaz;Poorolajal, Jalal
背景资料：氨甲环酸（TXA）对功能性鼻内窥镜手术（FESS）术中出血和术野改善的影响尚不清楚。本研究是为了回答这个问题。方法：本试验是在2013年4月至11月在伊朗哈马丹Beasat医院进行的60例慢性鼻窦炎患者中进行的。干预组30例，术前每侧鼻腔内放置3块含5%血栓素A和0.5%苯巴比妥的纱布，浸泡10 min。对照组30例，用0.5%苯乙哌啶注射，方法同前。在手术开始后15、30和45分钟使用Boezaart分级评估出血量和术野质量。第一季度，干预组的术野质量明显优于对照组（P = 0.002）和第二季度（P = 0.003），但不是在第三季度（P = 0.163）。结论：TXA局部应用可有效减少FESS术中出血量，改善手术视野。基于这些发现，局部TXA可能是在使用后的前30分钟内提供合适手术野的有用方法。
Background: The effect of tranexamic acid (TXA) on bleeding and improvement of surgical field during functional endoscopic sinus surgery (FESS) is not clear yet. This study was conducted to answer this question.Methods: This trial was conducted on 60 patients with chronic sinusitis at Beasat Hospital, Hamadan, Iran, from April to November 2013. Thirty patients in the intervention group received three pledgets soaked with TXA 5% and phenylephrine 0.5% for 10 minutes in each nasal cavity before surgery. Thirty patients in the control group received phenylephrine 0.5% with the same way. The amount of bleeding and the quality of surgical field were evaluated at 15, 30, and 45 minutes after the start of surgery using Boezaart grading.Results: The quality of the surgical field in the intervention group compared to the control group was significantly better in the first quarter (P = 0.002) and the second quarter (P = 0.003) but not in the third quarter (P = 0.163). Furthermore, the amount of bleeding was much less during all periods in the intervention group than in the control group (P = 0.001).Conclusion: Topical TXA can efficiently reduce bleeding and improve the surgical field in FESS in patients with rhinosinusitis. Based on these findings, topical TXA may be a useful method for providing a suitable surgical field during the first 30 minutes after use.