| 摘要: |
| 目的:系统评价氨甲环酸(TXA)在儿童颅缝闭锁手术中的有效性和安全性,为临床用药提供循证依据。方法:计算机检
索PubMed、EMBase、the Cochrane Library、Web of Science、中国知网、维普和万方数据库,收集关于氨甲环酸在儿童颅缝闭锁手术
中的随机对照试验(RCT)。检索时限为建库至2023 年12 月31 日。筛选文献、提取资料并采用Cochrane 协作偏倚风险评价工
具对纳入的RCT 进行质量评价,采用RevMan 5. 3 软件进行Meta 分析。结果:纳入研究5 项,共计220 例患儿。Meta 分析结果
显示,与对照组相比,试验组能够降低术中失血量(MD=-18. 64,95%CI -31. 50~ -5. 78,P = 0. 004)、围手术期总失血量(MD=
-25. 55,95%CI -43. 16~-7. 94,P =0. 004)、术中输血量(红细胞,MD=-7. 70,95%CI -10. 74~ -4. 66,P<0. 01)、围手术期总输
血量(红细胞,MD=-14. 24,95%CI -27. 00~-1. 48,P =0. 03);试验组与对照组术后失血量、术后输血量(红细胞)及手术持续时
间比较差异无统计学意义。有1 项研究有不良事件报道。结论:在儿童颅缝闭锁手术中,与安慰剂或无干预相比,TXA 可减少
失血量和输血需求。同时,10 mg/ kg 的负荷剂量及5 mg/ (kg∙h)的维持剂量方案可推荐应用于临床。 |
| 关键词: 氨甲环酸 颅缝闭锁手术 儿童 Meta 分析 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.04.009 |
|
| 基金项目:昆明市卫生科技人才培养项目,编号2023-SW(技)-19。 |
|
| Meta-Analysis on Efficacy and Safety of Tranexamic Acid in Children with Craniosynostosis Surgery |
| Ren Danyang1, Shen Jianling1, Tu Caixia1, Yang Yanming1, Xie Rui2, Li Yunwei1, Li Lin1, Li Huiying1 |
| ((1. Kunming Children’s Hospital, Kunming 650228, China; 2. Kunming Medical University, Kunming 650500, China)) |
| Abstract: |
| Objective: To systematically review the efficacy and safety of tranexamic acid in children with craniosynostosis surgery, and
to provide evidence-based reference for clinical drug use. Methods: PubMed, EMBase, the Cochrane Library, Web of Science, CNKI,
VIP and Wanfang databases were retrieved to collect randomized controlled trials ( RCT) of tranexamic acid in children with
craniosynostosis surgery. The retrieval time was from the database establishment to Dec. 31st , 2023. Literature screening and data
extraction were performed, the quality of included RCT were evaluated by bias risk assessment tool recommended by Cochrane system
evaluator manual, RevMan 5. 3 software was used for Meta-analysis. Results: A total of 5 articles were enrolled, including 220 patients.
Meta-analysis showed that compared with control group, TXA could significantly reduce intraoperative blood loss (MD=-18. 64, 95%CI
-31. 50 to -5. 78, P =0. 004), perioperative total blood loss (MD= -25. 55, 95%CI -43. 16 to -7. 94, P = 0. 004), intraoperative
blood transfusion (red blood cells, MD=-7. 70, 95%CI -10. 74 to -4. 66, P<0. 01), perioperative total blood transfusion (red blood
cells, MD=-14. 24, 95%CI -27. 00 to -1. 48, P =0. 03). There was no statistical significance between two groups in the postoperative
blood loss, postoperative blood transfusion (red blood cells) and surgical time. Adverse events were reported in 1 study. Conclusion: In
pediatric craniosynostosis surgery, TXA can reduce blood loss and blood transfusion compared with placebo or no intervention. Meanwhile,
10 mg/ kg load dose and 5 mg/ (kg∙h) continuous infusion dose regimen can be recommended for clinical use. |
| Key words: tranexamic acid craniosynostosis surgery children Meta-analysis |
