PDF(Pubmed)
Abstract：
UNASSIGNED: Tranexamic acid (TXA) has gained popularity in spinal surgery because of its potential to reduce blood loss. However, concerns regarding its safety and efficacy remain. This systematic review and meta-analysis aimed to evaluate the efficacy of TXA in reducing blood loss and its safety profile in spinal surgeries.
UNASSIGNED: A comprehensive search was conducted in electronic databases for randomized controlled trials and prospective studies evaluating the use of TXA in spinal surgery. The primary outcomes were intraoperative and total estimated blood loss (EBL), and the secondary outcomes included the incidence and types of complications associated with TXA use. Meta-analyses were performed using random-effects models.
UNASSIGNED: Thirteen studies involving 1,213 participants were included in the meta-analysis. The use of TXA was associated with significant reductions in both intraoperative (mean difference: -46.56 mL [-73.85, -19.26], p<0.01]) and total EBL (mean difference: -210.17 mL [-284.93, -135.40], p<0.01) while also decreasing the need for blood transfusions (risk ratio: 0.68 [0.51, 0.90], p<0.01). No significant difference was found in the incidence and types of thrombotic complications when TXA was used in spinal surgery. Subgroup analysis showed consistent results in instrumentation and fusion surgery and different doses of TXA.
UNASSIGNED: TXA is effective in reducing intraoperative and overall blood loss in spinal surgery without increasing the risk of complications. These findings support the use of TXA to improve patient outcomes. However, caution should be exercised because of the heterogeneity among the included studies. Further research is needed to confirm these findings and explore potential long-term complications.
UNASSIGNED: A comprehensive search was conducted in electronic databases for randomized controlled trials and prospective studies evaluating the use of TXA in spinal surgery. The primary outcomes were intraoperative and total estimated blood loss (EBL), and the secondary outcomes included the incidence and types of complications associated with TXA use. Meta-analyses were performed using random-effects models.
UNASSIGNED: Thirteen studies involving 1,213 participants were included in the meta-analysis. The use of TXA was associated with significant reductions in both intraoperative (mean difference: -46.56 mL [-73.85, -19.26], p<0.01]) and total EBL (mean difference: -210.17 mL [-284.93, -135.40], p<0.01) while also decreasing the need for blood transfusions (risk ratio: 0.68 [0.51, 0.90], p<0.01). No significant difference was found in the incidence and types of thrombotic complications when TXA was used in spinal surgery. Subgroup analysis showed consistent results in instrumentation and fusion surgery and different doses of TXA.
UNASSIGNED: TXA is effective in reducing intraoperative and overall blood loss in spinal surgery without increasing the risk of complications. These findings support the use of TXA to improve patient outcomes. However, caution should be exercised because of the heterogeneity among the included studies. Further research is needed to confirm these findings and explore potential long-term complications.
摘要：
■氨甲环酸（TXA）由于具有减少失血的潜力而在脊柱手术中获得了普及。然而,对其安全性和有效性的担忧仍然存在。本系统综述和荟萃分析旨在评估TXA在脊柱手术中减少失血的功效及其安全性。
■在电子数据库中对评估TXA在脊柱外科中使用的随机对照试验和前瞻性研究进行了全面搜索。主要结果是术中和总估计失血量（EBL），次要结局包括TXA使用相关并发症的发生率和类型.采用随机效应模型进行Meta分析。
■13项研究纳入荟萃分析，涉及1,213名参与者。TXA的使用与两种术中的显着减少相关（平均差异：-46.56mL[-73.85，-19.26]，p<0.01]）和总EBL（平均差：-210.17mL[-284.93，-135.40]，p<0.01），同时也降低了输血的需要（风险比：0.68[0.51，0.90]，p<0.01)。在脊柱手术中使用TXA时，血栓性并发症的发生率和类型没有显着差异。亚组分析显示，器械和融合手术以及不同剂量的TXA的结果一致。
■TXA可有效减少脊柱手术中的术中和整体失血，而不会增加并发症的风险。这些发现支持使用TXA改善患者预后。然而,由于纳入研究的异质性，应谨慎行事。需要进一步的研究来证实这些发现并探索潜在的长期并发症。
■在电子数据库中对评估TXA在脊柱外科中使用的随机对照试验和前瞻性研究进行了全面搜索。主要结果是术中和总估计失血量（EBL），次要结局包括TXA使用相关并发症的发生率和类型.采用随机效应模型进行Meta分析。
■13项研究纳入荟萃分析，涉及1,213名参与者。TXA的使用与两种术中的显着减少相关（平均差异：-46.56mL[-73.85，-19.26]，p<0.01]）和总EBL（平均差：-210.17mL[-284.93，-135.40]，p<0.01），同时也降低了输血的需要（风险比：0.68[0.51，0.90]，p<0.01)。在脊柱手术中使用TXA时，血栓性并发症的发生率和类型没有显着差异。亚组分析显示，器械和融合手术以及不同剂量的TXA的结果一致。
■TXA可有效减少脊柱手术中的术中和整体失血，而不会增加并发症的风险。这些发现支持使用TXA改善患者预后。然而,由于纳入研究的异质性，应谨慎行事。需要进一步的研究来证实这些发现并探索潜在的长期并发症。
