关键词: blepharoplasty blood loss ecchymosis edema intravenous tranexamic acid plastic surgery rhinoplasty surgery tbl

来  源:   DOI:10.7759/cureus.62482   PDF(Pubmed)

Abstract:
With increasing interest in aesthetic plastic procedures, the event of blood loss has compromised patients\' safety and satisfaction. Tranexamic acid (TXA) is a drug used for the reduction of blood loss during surgical procedures. This systematic review aims to evaluate the clinical efficacy and safety of TXA in aesthetic plastic surgery for the reduction of bleeding and related complications. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Electronic databases PubMed, EMBASE, Cochrane Library, and Google Scholar were searched. The medical subject headings (MeSH) keywords used for data extraction were (\"TXA,\" OR \"tranexamic acid,\") AND (\"plastic surgery,\" OR \"aesthetic surgery,\" OR \"rhinoplasty,\" OR \"blepharoplasty,\") AND (\"blood loss\" OR \"bleeding\" OR \"TBL\") AND (\"Edema\" OR \"ecchymosis\"). A combination of these MeSH terms was used in the literature search. The timeline of research was set from 2015 to January 2024. A total of 7380 research articles were identified from the above-mentioned databases, and only 13 research articles met the inclusion criteria. There was a significant difference in total blood loss (TBL) among patients who had undergone plastic surgery procedures while on TXA as compared to a placebo (mean difference = -6.02; Cl: -1.07 to -0.16; p > 0.00001), and heterogeneity was found (degrees of freedom (df) = 9; I2 = 97%). Only two studies reported the average ecchymosis scores after TXA among interventions in comparison to the placebo group. This review provides evidence that TXA lowers TBL, ecchymosis, edema, and anemia during cosmetic surgery without significantly increasing thromboembolic consequences.
摘要:
随着人们对美学塑化程序的兴趣日益增加,失血事件损害了患者的安全性和满意度。氨甲环酸(TXA)是一种用于减少手术过程中失血的药物。本系统综述旨在评估TXA在美容整形手术中减少出血和相关并发症的临床疗效和安全性。遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目。电子数据库PubMed,EMBASE,科克伦图书馆,和谷歌学者被搜索。用于数据提取的医学主题词(MeSH)关键词是(\“TXA,“或”氨甲环酸,\")和(\"整形手术,“或”美容手术,“或”隆鼻手术,“或”眼睑成形术,\")和(\"失血\"或\"出血\"或\"TBL\")和(\"水肿\"或\"瘀斑\")。在文献检索中使用这些MeSH术语的组合。研究时间表定为2015年至2024年1月。从上述数据库共识别出7380篇研究文章,只有13篇研究文章符合纳入标准。与安慰剂相比,接受TXA整形手术的患者的总失血量(TBL)存在显着差异(平均差=-6.02;Cl:-1.07至-0.16;p>0.00001),并发现异质性(自由度(df)=9;I2=97%)。与安慰剂组相比,只有两项研究报告了TXA干预后的平均瘀斑评分。这篇综述提供了TXA降低TBL的证据,瘀斑,水肿,和贫血在整容手术期间没有显着增加血栓栓塞的后果。
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