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Application of Tranexamic Acid in Shoulder Arthroscopic Surgery: A Randomised Controlled Trial
- Affiliations：
1. 1Department of Orthopedic Trauma, Hebei Medical University Third Affiliated Hospital, Shijiazhuang 050051, China
2. 2Medical Services Section, Hebei Medical University Third Affiliated Hospital, Shijiazhuang 050051, China
3. 3Department of Ultrasonography, Hebei Medical University Third Affiliated Hospital, Shijiazhuang 050051, China
4. 4河北医科大学研究生院，石家庄 050011
4. 4Graduate School of Hebei Medical University, Shijiazhuang 050011, China
- Author bio：
*Lubo99@aliyun.com
- Funds：
DOI：10.24920/004295
CLC：Received：23 August 2023，
Accepted：2023-11-22，
Published Online：15 January 2024，
Published：30 December 2023
- Accepted：
Scan QR Code
Tian-Ci Wang, Jia-Liang Guo, Qiu-Ping Tian, et al. Application of Tranexamic Acid in Shoulder Arthroscopic Surgery: A Randomised Controlled Trial[J]. Chinese medical sciences journal, 2023, 38(4): 273-278.
Tian-Ci Wang, Jia-Liang Guo, Qiu-Ping Tian, et al. Application of Tranexamic Acid in Shoulder Arthroscopic Surgery: A Randomised Controlled Trial[J]. Chinese medical sciences journal, 2023, 38(4): 273-278. DOI： 10.24920/004295.
摘要
目的
手术中出血会降低视觉清晰度。氨甲环酸具有良好的止血效果，在骨科手术中被广泛使用。但是有关氨甲环酸在肩关节镜手术中应用的研究较少。本研究旨在探索氨甲环酸在肩关节镜手术中的最佳给药途径。
方法
将接受关节镜下肩袖修复手术的患者随机分为对照组、静脉组、冲洗组和静脉+冲洗组。静脉注射组在手术前10分钟静脉注射氨甲环酸。冲洗组在肩峰下减压和肩峰成形过程中向冲洗液中加入氨甲环酸。静脉+冲洗组在手术前10分钟静脉注射氨甲环酸，同时在肩峰下减压和肩峰成形过程中向冲洗液中加入氨甲环酸。主要评价指标为视觉清晰度评分，次要评价指标为肩峰下减压和肩峰成形操作的冲洗液消耗量以及操作时间。
结果
纳入134例患者，其中对照组33例，静脉组35例，冲洗组32例，静脉+冲洗组34例。静脉组、冲洗组和静脉+冲洗组的视觉清晰度评分分别为2.70（2.50，2.86）（
Z
= -3.677，
P
= 0.002）、2.67（2.50，2.77）（
Z
= -3.058，
P
<
0.001）和2.91（2.75，3.00）（
Z
= -6.634，
P
<
0.001），显著高于对照组[2.44（2.37，2.53）
]
。对照组消耗的冲洗液多于静脉组（4
659.71 ± 549.31）、冲洗组（4
574.69 ± 1
222.31）及静脉+冲洗组（2
986.18 ± 724.91）（
P
<
0.05）。静脉+冲洗组消耗的冲洗液少于静脉组和冲洗组（
P
<
0.05）。各组在肩峰下减压和肩峰成形术时间方面的差异无统计学意义。
结论
不论是局部应用还是系统给药，氨甲环酸系统均能提高肩关节镜术中视觉清晰度，两种给药途径联合应用效果更佳。
Abstract
Objective
To explore the optimal administration route of tranexamic acid (TXA) in shoulder arthroscopic surgery.
Methods
Patients undergoing arthroscopic rotator cuff repair were randomly divided into four groups: control group (without TXA treatment)
intravenous group (TXA was intravenously administered 10 minutes before surgery)
irrigation group (TXA was added to the irrigation fluid during subacromial decompression and acromioplasty)
and intravenous plus irrigation group (TXA was applied both intravenously and
via
intra-articular irrigation). The primary outcome was visual clarity assessed with visual analog scale (VAS) score
and the secondary outcomes included irrigation fluid consumption and time to subacromial decompression and acromioplasty procedure.
Results
There were 134 patients enrolled in the study
including 33 in the control group
35 in the intravenous group
32 in the irrigation group
and 34 in the intravenous plus irrigation group. The median and interquartile range of VAS scores for the intravenous
irrigation
and intravenous plus irrigation groups were 2.70 (2.50
2.86) (
Z
= -3.677
P
= 0.002)
2.67 (2.50
2.77) (
Z
= -3.058
P
<
0.001)
and 2.91 (2.75
3.00) (
Z
= -6.634
P
<
0.001)
respectively
significantly higher than that of the control group [2.44 (2.37
2.53)
]
. Moreover
the control group consumed more irrigation fluid than the intravenous group
irrigation group
and intravenous plus irrigation group (all
P
<
0.05). The intravenous plus irrigation group consumed less irrigation fluid than either the intravenous group or the irrigation group (both
P
<
0.001). There was no difference i
n subacromial decompression and acromioplasty operative time among the four groups.
Conclusion
TXA applied both topically and systematically can improve intraoperative visual clarity
and the combined application is more effective.
关键词
Keywords
references
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