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目的探讨使用氨甲环酸预防剖宫产术中术后出血的有效性及安全性。方法检索万方、中国知网(CNKI)和Pub Med数据库,共检索出224篇文献,按统一标准筛选,最终纳入14项随机对照试验研究,使用Stata 11.0软件进行Meta分析。结果此次研究共纳入氨甲环酸处理组1 383人,对照组1 392人。Meta分析结果显示:与对照组相比,使用氨甲环酸可显著降低剖宫产手术总出血量(WMD=-156.3,95%CI=-204.2~-108.4,P<0.001)、术中出血量(WMD=-127.1,95%CI=-180.6~-73.6,P<0.001)及术后2 h出血量(WMD=-47.1,95%CI=-64.3~-30.0,P<0.001)。按氨甲环酸剂量(1 g或10 mg/kg)和种族进行亚组分析后,差异仍具有统计学意义(P<0.05)。结论氨甲环酸处理可明显降低剖宫产手术术中及术后出血量。
Objective To explore the use of tranexamic acid in the prevention of postoperative bleeding in cesarean section, the effectiveness and safety. METHODS: CNKI and Pub Med databases were searched. A total of 224 articles were retrieved and screened according to a uniform standard. Finally, 14 randomized controlled trials were conducted, and Stata 11.0 software was used for meta-analysis. Results A total of 1 383 patients in the tranexamic acid treatment group and 1 392 in the control group were enrolled in this study. Meta-analysis showed that, compared with the control group, the use of tranexamic acid can significantly reduce the total amount of bleeding after cesarean section (WMD = -156.3, 95% CI = -204.2 ~ -108.4, P <0.001), intraoperative bleeding (WMD = -127.1,95% CI = -180.6 ~ -73.6, P <0.001) and 2 h postoperative bleeding volume (WMD = -47.1,95% CI = -64.3 ~ -30.0, P <0.001). The difference was statistically significant (P <0.05) after subgroup analysis with tranexamic acid (1 g or 10 mg / kg) and race. Conclusion Tranexamic acid treatment can significantly reduce intraoperative and postoperative bleeding after cesarean section.