UNASSIGNED: This systematic review utilized PubMed, Ovid, CINAHL, Clinical Key, Medline, and Embase, and the search was conducted through December 22, 2022. Key words used in the search included: \"tranexamic acid,\" \"TXA,\" \"foot,\" \"ankle,\" \"calcaneal,\" and \"surgery.\" The outcomes within the studies analyzed included measures of perioperative blood loss (intra-operative blood loss, 24-hour post-operative blood loss, blood loss from hour 24 to hour 48, post-operative hemoglobin (Hgb), and post-operative hematocrit [Hct]), as well as wound complications and vascular events. Meta-regression was included to assess the impact of age on between-study variation.
UNASSIGNED: Ten studies met preliminary inclusion criteria. Upon further inspection, eight met full inclusion criteria for the meta-analysis. Despite a growing amount of literature on the topic, there is still a paucity of literature published on TXA use in foot and ankle surgery. Current literature suggests that foot and ankle surgery patients treated with TXA may have reduced 24-hour post-operative blood loss (MD=-183.41 mL, 95% CI=-247.49 to -119.34 mL, p<0.001), increased post-operative hemoglobin (MD=0.71 g/dL, 95% CI=0.11 to 1.31 g/dL, p=0.020) and hematocrit (MD=2.66%, 95% CI=0.07 to 5.24%, p=0.040) when compared to similar patients not receiving TXA. The use of TXA in foot and ankle surgery did not lead to increased thromboembolic complications. Meta-regression indicated no clinically relevant association of age to between-study variation.
UNASSIGNED: TXA was found to be a safe treatment that did affect wound healing or infection rates while decreasing perioperative blood loss. Further research should be performed to evaluate the long-term effects of TXA administration on patient outcomes after foot and ankle surgery.
■本系统综述利用PubMed,奥维德,CINAHL,临床关键,Medline,和Embase,搜索进行到2022年12月22日。搜索中使用的关键词包括:“氨甲环酸,\"\"TXA,\"\"脚,\"\"脚踝,\"\"跟骨,“和”手术。“分析的研究结果包括围手术期失血的测量(术中失血,术后24小时失血,24小时至48小时失血,术后血红蛋白(Hgb),和术后血细胞比容[Hct]),以及伤口并发症和血管事件。纳入Meta回归以评估年龄对研究间变异的影响。
■10项研究符合初步纳入标准。经进一步检查,8人符合meta分析的完全纳入标准.尽管关于这个话题的文献越来越多,关于TXA在足踝手术中的应用的文献仍然很少。目前的文献表明,接受TXA治疗的足踝手术患者术后24小时失血量可能减少(MD=-183.41mL,95%CI=-247.49至-119.34mL,p<0.001),术后血红蛋白增加(MD=0.71g/dL,95%CI=0.11至1.31g/dL,p=0.020)和血细胞比容(MD=2.66%,95%CI=0.07至5.24%,与未接受TXA的类似患者相比,p=0.040)。在足踝手术中使用TXA不会导致血栓栓塞并发症的增加。荟萃回归表明年龄与研究之间的差异没有临床相关的关联。
■TXA被发现是一种安全的治疗方法,可以影响伤口愈合或感染率,同时减少围手术期失血量。应进行进一步的研究以评估TXA给药对足踝手术后患者预后的长期影响。