The Effect of Tranexamic Acid on Blood Loss During Orthognathic Surgery: A Randomized Controlled Trial
The Effect of Tranexamic Acid on Blood Loss During Orthognathic Surgery: A Randomized Controlled Trial
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DOI：
10.1016/j.joms.2008.08.015
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发表时间：
2009-01-01
影响因子：
1.9
通讯作者：
Samman, Nabil
中科院分区：
文献类型：
--
作者：
Choi, Wing Shan;Irwin, Michael G.;Samman, Nabil
目的：氨甲环酸已被用于减少失血和随后的输血需要在骨科，脊柱和心脏手术。颌外科手术可能与严重出血有关，但其在这种情况下的疗效尚不清楚。本研究的目的是探讨氨甲环酸对失血的影响，在biuminous osteotomy.Patients和方法：七十三个连续的患者，择期biuminous osteotomy，被列入这个双盲，随机，对照试验。他们在手术前静脉注射氨甲环酸（20 mg/kg）或安慰剂（生理盐水）。所有患者均接受轻度诱导性低血压，并根据标准方案进行手术。记录术中失血量、手术时间、血液制品输注、围手术期血红蛋白和红细胞压积。与对照组相比，氨甲环酸组上颌手术总失血量和术中失血量明显减少（分别为878.6 +/- 577.7 mL vs 1，257.2 +/- 817.8 mL和428.0 +/- 233.3 mL vs 643.8 +/- 430.0 mL; P <0.05）。仅考虑手术时间和治疗组，对照组的平均总失血量比氨甲环酸组多422 mL（P <0.001）。输血或住院时间的长度之间没有显着差异2 groups.Conclusion：术前静脉推注氨甲环酸在20 mg/kg减少失血量与安慰剂相比，在双颌截骨术。(c)2009年美国口腔颌面外科医师协会
Purpose: Tranexamic acid has been used to reduce blood loss and the subsequent need for transfusion in orthopedic, spinal, and cardiac surgery. Orthognathic surgery can be associated with significant bleeding yet its efficacy in this setting is not clear. The purpose of this study was to investigate the effect of tranexamic acid on blood loss during bimaxillary osteotomy.Patients and Methods: Seventy-three consecutive patients, scheduled for elective bimaxillary osteotomy, were included in this double blind, randomized, controlled trial. They received either a bolus of tranexamic acid (20 mg/kg) or placebo (normal saline) intravenously just before surgery. All patients received induced mild hypotension and had surgery according to a standard protocol. Intraoperative blood loss, operation time, transfusion of blood products, perioperative hemoglobin, and hematocrit were recorded.Results: The total blood loss and blood loss during maxillary surgery was reduced significantly in the tranexamic acid group compared with the control group (878.6 +/- 577.7 mL vs 1,257.2 +/- 817.8 mL and 428.0 +/- 233.3 mL vs 643.8 +/- 430.0 mL, respectively; P < .05). Considering the duration of operation and the treatment groups only, the mean total blood loss in the control group was 422 mL more than that in the tranexamic acid group (P < .001). There was no significant difference in blood transfusion or the length of hospital stay between the 2 groups.Conclusion: Preoperative intravenous bolus administration of tranexamic acid at 20 mg/kg reduces blood loss compared with placebo during bimaxillary osteotomy. (c) 2009 American Association of Oral and Maxillofacial Surgeons