Abstract：
OBJECTIVE: The purpose of current systematic review and meta-analysis is to determine the efficacy and safety of the administration of tranexamic acid in patients undergoing PCNL. The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. This systematic review and meta-analysis includes randomized comparative prospective studies.
RESULTS: The primary endpoints were the hemoglobin drop, the bleeding complications, and the transfusion rate. Secondary endpoints included the operative time, the stone-free rate, the hospital stay, and the overall complications. Two-thousand five-hundred six publications were screened for this study. Six RCTs (1262 patients) were included in the meta-analysis. As for our primary endpoints, the hemoglobin drop was lower in the tranexamic group than in the control group, with mean difference (MD) of - 0.65 (p < 0.0001); the bleeding complications were rarer in the tranexamic group than in the control group, with an odds ratio (OR) of 0.32 (p < 0.00001); and the transfusion rate was lower in the tranexamic group with an OR of 0.34 (p = 0.0007). Concerning the secondary endpoints, the operative time was less in the tranexamic group with an MD of - 10.39 (p < 0.0001), the meta-analysis of the stone-free status data showed no statistical significance between the two groups with an OR of 1.58 (p = 0.09), the hospital stay was significantly less in the tranexamic group with an MD of - 1.38 (p = 0.005), and the overall complications were rarer in the tranexamic group than in the control group with an OR of 0.34 (p = 0.12). The peri-operative use of TA contributes to the reduction of blood loss, bleeding complications, mean operative time, and hospital stay. The use of TA seemed to be safe and well tolerated in patients undergoing PCNL. PROSPERO protocol (Registration number: CRD42019122818).
RESULTS: The primary endpoints were the hemoglobin drop, the bleeding complications, and the transfusion rate. Secondary endpoints included the operative time, the stone-free rate, the hospital stay, and the overall complications. Two-thousand five-hundred six publications were screened for this study. Six RCTs (1262 patients) were included in the meta-analysis. As for our primary endpoints, the hemoglobin drop was lower in the tranexamic group than in the control group, with mean difference (MD) of - 0.65 (p < 0.0001); the bleeding complications were rarer in the tranexamic group than in the control group, with an odds ratio (OR) of 0.32 (p < 0.00001); and the transfusion rate was lower in the tranexamic group with an OR of 0.34 (p = 0.0007). Concerning the secondary endpoints, the operative time was less in the tranexamic group with an MD of - 10.39 (p < 0.0001), the meta-analysis of the stone-free status data showed no statistical significance between the two groups with an OR of 1.58 (p = 0.09), the hospital stay was significantly less in the tranexamic group with an MD of - 1.38 (p = 0.005), and the overall complications were rarer in the tranexamic group than in the control group with an OR of 0.34 (p = 0.12). The peri-operative use of TA contributes to the reduction of blood loss, bleeding complications, mean operative time, and hospital stay. The use of TA seemed to be safe and well tolerated in patients undergoing PCNL. PROSPERO protocol (Registration number: CRD42019122818).
摘要：
目的：当前系统评价和荟萃分析的目的是确定接受PCNL的患者服用氨甲环酸的有效性和安全性。根据系统评价和荟萃分析的首选报告项目（PRISMA）进行研究。本系统综述和荟萃分析包括随机比较前瞻性研究。
结果：主要终点是血红蛋白下降，出血并发症,和输血率。次要终点包括手术时间，无石率，住院,和整体并发症。这项研究筛选了两千五百六篇出版物。六个RCTs（1262例患者）被纳入荟萃分析。至于我们的主要终点，氨甲环组的血红蛋白下降低于对照组，平均差异（MD）为-0.65（p<0.0001）；氨甲环组的出血并发症比对照组少，比值比(OR)为0.32(p<0.00001);氨甲环组的输血率更低,OR为0.34(p=0.0007)。关于次要终点，氨甲环组的手术时间更短，MD为-10.39（p<0.0001），无结石状态数据的荟萃分析显示两组之间无统计学意义，OR为1.58（p=0.09），氨甲环组的住院时间明显减少，MD为-1.38（p=0.005），与对照组相比，氨甲环组的总体并发症较少，OR为0.34（p=0.12）。围手术期使用TA有助于减少失血,出血并发症,平均手术时间，住院。在接受PCNL的患者中，使用TA似乎是安全且耐受性良好的。PROSPERO协议(注册号:CRD42019122818)。
结果：主要终点是血红蛋白下降，出血并发症,和输血率。次要终点包括手术时间，无石率，住院,和整体并发症。这项研究筛选了两千五百六篇出版物。六个RCTs（1262例患者）被纳入荟萃分析。至于我们的主要终点，氨甲环组的血红蛋白下降低于对照组，平均差异（MD）为-0.65（p<0.0001）；氨甲环组的出血并发症比对照组少，比值比(OR)为0.32(p<0.00001);氨甲环组的输血率更低,OR为0.34(p=0.0007)。关于次要终点，氨甲环组的手术时间更短，MD为-10.39（p<0.0001），无结石状态数据的荟萃分析显示两组之间无统计学意义，OR为1.58（p=0.09），氨甲环组的住院时间明显减少，MD为-1.38（p=0.005），与对照组相比，氨甲环组的总体并发症较少，OR为0.34（p=0.12）。围手术期使用TA有助于减少失血,出血并发症,平均手术时间，住院。在接受PCNL的患者中，使用TA似乎是安全且耐受性良好的。PROSPERO协议(注册号:CRD42019122818)。
