Meta-Analysis Of The Effect Of Tranexamic Acid On The Perioperative Period Of Patients With Intertrochanteric Fracture Under Going PFNA Operation

Objective:The report on the perioperative impact of preoperative intravenous infusion of tranexamic acid(TXA)on patients with intertrochanteric fracture(IFF)undergoing PFNA surgery in the past three years is now analyzed and sorted out,using the statistical method of meta-analysis to analyze and compare Compared with the blank control group,the preoperative intravenous drip of tranexamic acid affects patients during the perioperative period of PFNA surgery.Methods:According to the proposed search strategy,computers are used to search English databases such as Pubmed,Emabase,The cochrane Library,and Web Of Science,as well as Chinese databases such as the VIP database and Wanfang database.The publication time of the literature is limited from December 2017 to December 2020.Search for the effect of intravenous infusion of tranexamic acid before surgery on patients during the perioperative period of anti-rotation intramedullary nail fixation(PFNA)on the proximal femur compared with the blank control group.The evaluation of the outcome includes operation time,hemoglobin volume on the third day after surgery,total perioperative blood loss,surgical blood loss,postoperative drainage,hidden blood loss,postoperative venous embolism complications,and the rate of patient blood transfusion Wait.Strictly screened according to the inclusion and exclusion criteria,and carried out quality assessment,and finally imported the data into Rev Man 5.4 software for analysis.P<0.05 considered the results to be statistically different.Results:Through a careful search of major Chinese and foreign literature libraries,it was found that in the past three years,9 documents met the requirements of the above method,including 2 English documents and 7 Chinese documents.The IFF patients in the 9 articles were divided into two groups,the experimental group and the control group.Both surgical methods were PFNA.The experimental group(preoperative intravenous infusion of tranexamic acid)and the control group(only normal saline or blank For comparison,the hemoglobin content was high on the third postoperative day [WMD =8.67,95% CI(6.53,10.08),P<0.00001 ],and the patient’s blood transfusion rate was low [WMD = 0.31,95% CI(0.15,0.61),P<0.05 ],low intraoperative blood loss [WMD=-15.08,95% CI(-27.69,-2.47),P=0.02],low total blood loss [WMD =-176.24,95% CI(-235.19,-117.28),P<0.00001],low hidden blood loss [WMD =-149.03,95% CI(-203.04,-95.03),P<0.00001 ].Operation time [WMD= 0.07,95% CI(-1.48,1.61),P= 093 ],postoperative venous system embolism complications [WMD= 0.56,95% CI(0.23,1.38),P= 0.21 ],etc.Statistical difference.conclusionPreoperative low-dose intravenous tranexamic acid for patients with intertrochanteric fractures undergoing anti-rotation intramedullary nail fixation of the proximal femur can reduce the patient’s intraoperative blood loss,hidden blood loss,total blood loss,and postoperative blood transfusion It can increase the amount of hemoglobin on the third day after surgery without increasing the risk of venous system embolism,and has no effect on the operation time.