氨甲环酸(TXA)在整形外科中的临床应用。

IF 3.2 2区 医学 Q1 SURGERY
Plastic and reconstructive surgery Pub Date : 2024-12-01 Epub Date: 2024-01-10 DOI:10.1097/PRS.0000000000011288
Stav Brown, Tal Brown, Rod J Rohrich
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引用次数: 0

摘要

目的:氨甲环酸(TXA)作为整形外科中一种重要的药理制剂已得到越来越多的认可。本研究回顾了 TXA 用于各种整形和重建手术的科学证据,为在各种整形外科手术中安全有效地使用 TXA 提供临床建议:方法:按照 PRISMA 指南进行了系统综述和荟萃分析。采用既定的评估程序对文章质量进行评分(建议评估、制定和评价分级方法):结果:共纳入了 45 项关于在整形外科中使用 TXA 的研究。中度确定性证据支持在颅面外科手术中静脉注射 TXA,以减少失血和输血需求。有高度确定性的证据支持在整容手术中使用 TXA 和在鼻整形手术中静脉注射 TXA 以减少失血。还需要进一步的高级别研究来确定 TXA 对拉皮手术和乳房相关手术中血肿发生率的影响。有中度确定性证据支持在烧伤护理中使用 TXA。还需要进一步研究,才能对显微手术中使用 TXA 的效果做出定量结论:这是迄今为止关于在整形外科中使用 TXA 的最大规模研究,也是首个提供临床建议的研究。文献强调了 TXA 在颅颌面外科、整容外科和烧伤护理领域的重要作用。要就 TXA 对整容手术中瘀斑和水肿的影响得出定量结论,需要进行标准化的客观测量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Applications of Tranexamic Acid in Plastic and Reconstructive Surgery.

Background: Tranexamic acid (TXA) has gained increasing recognition as a valuable pharmacologic agent within plastic surgery. This study reviews the scientific evidence regarding the use of TXA in the full range of plastic and reconstructive surgery to provide clinical recommendations for safe and effective use in various plastic surgical procedures.

Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. An established appraisal process was used to rate the quality of articles (Grading of Recommendations Assessment, Development, and Evaluation methodology).

Results: Forty-five studies describing the use of TXA in plastic surgery were included. There is moderate-certainty evidence to support the use of intravenous administration of TXA in craniofacial surgery procedures to reduce blood loss and transfusion requirements. There is high-certainty evidence to support the use of TXA in cosmetic surgery and intravenous administration in rhinoplasty procedures to reduce blood loss. Further high-level studies are needed to determine TXA's effects on hematoma rates in face-lift surgery and breast-related procedures. There is moderate-certainty evidence to support the use of TXA in burn care. Further studies are required to provide quantitative conclusions on the effects of TXA administration in microsurgery.

Conclusions: This is the largest study to date on the use of TXA in plastic surgery and the first to provide clinical recommendations. The literature highlights TXA's promising role in the fields of craniofacial surgery, cosmetic surgery, and burn care. Standardized, objective measurements are required to provide quantitative conclusions regarding TXA's effects on ecchymoses and edema in cosmetic surgery procedures.

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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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