摘要：Objective The present meta-analysis was conducted to compare the efficacy and safety of intravenous application of tranexamic acid (TXA) with placebo in patients with hip fracture undergoing hip surgeries. Methods PubMed, EMBASE and Cochrane Library were searched from inception until March 2018. A combined searching strategy of subject words and random words was adopted. Only randomized clinical trials were included. The comparisons regarding transfusion rate, total blood loss, intraoperative blood loss, postoperative blood loss, postoperative haemoglobin and postoperative thromboembolic complications were conducted. The meta-analysis was performed using Review Manager 5.3, and the bias evaluation was based on the Cochrane Handbook 5.1.0. Results Ten randomized controlled trials published from 2007 to 2018 were included in the meta-analysis. The results showed that there were significant differences in the two groups concerning transfusion rate of allogeneic blood [risk ratio (RR) = 0.66, 95% confidence interval (CI): 0.56 to 0.78, P = 0.003], total blood loss [mean difference (MD) = −273.00, 95% CI: −353.15 to −192.84, P < 0.00001], intraoperative blood loss (MD = −76.63, 95% CI: −139.55 to −13.71, P = 0.02), postoperative blood loss (MD = −125.29, 95% CI: −221.96 to −28.62, P = 0.01) and postoperative haemoglobin (MD = 0.80, 95% CI: 0.38 to 1.22, P = 0.0002). Nonsignificant differences were found in the incidence of thromboembolic events (RR = 1.38, 95% CI: 0.74 to 2.55, P = 0.31). Conclusions This meta-analysis of the available evidence implies that the intravenous route of TXA shows an ability to reduce transfusion requirements and total blood loss, not increasing the incidence of thromboembolic events in patients undergoing hip surgeries. The translational potential of this article The result of this meta-analysis shows that the utilization of intravenous TXA in patients with hip fracture undergoing hip surgeries possesses great potential in reducing blood loss and allogeneic blood transfusion safely.
关键词：Allogeneic blood transfusion ; Blood loss ; Hip fracture ; Meta-analysis ; Thromboembolic events ; Tranexamic acid ; Randomized controlled trial RCT ; Tranexamic acid TXA ; haemoglobin Hb ; total hip arthroplasty THA ; total knee arthroplasty TKA ; deep vein thrombolism DVT ; pulmonary embolism PE ; cerebrovascular accident CVA ; mean difference MD ; risk ratio RR ; standard deviation SD ; confidence interval CI
