中文摘要：

目的应用Meta分析方法评价局部应用氨甲环酸（TXA）在全髋关节置换（THA）中的有效性和安全性。方法利用计算机全面检索数据库Pub Med、the Cochrane Library、Ovid、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库中有关在全髋关节置换中局部应用氨甲环酸的相关文献,根据文献的研究类型、干预措施及研究对象等因素筛选出其中高质量的文献,同时手检纳入文献的参考文献作为补充材料,利用Cochrane协作网提供的Rev Man 5.3软件进行Meta分析,根据Meta分析结果评价局部应用氨甲环酸在全髋关节置换中的有效性和安全性。结果筛选出符合纳入标准的高质量文章11篇,共3 092例患者。Meta分析结果显示,与对照组相比,局部应用氨甲环酸组能够明显减少全髋关节置换患者的总失血量[MD=-333.93,95%CI（-425.91,-241.96）,P〈0.01],术后引流量[MD=-167.27,95%CI（-223.34,-111.21）,P〈0.01],术后血红蛋白丢失量[MD=-11.58,95%CI（-13.47,-9.69）,P〈0.01],能够明显降低输血率[OR=0.33,95%CI（0.25,0.43）,P〈0.01]和输血量[OR=-80.50,95%CI（-150.65,-10.35）,P〈0.05],而在深静脉血栓（DVT）、肺栓塞症（PE）发生率方面无统计学差异。结论局部应用TXA可明显减少THA手术失血量,降低输血率和输血量,并不增加深静脉血栓、肺栓塞症发生风险,应用在THA中具有良好的安全性和有效性。

英文摘要：

Objective To evaluate the efficacy and safety of the topical administration of tranexamic acid（ TXA） in total hip arthroplasty（ THA） using meta-analysis method. Methods The related trials concerning topical TXA application in THA were retrieved from Pub Med,Ovid,the Cochrane library,China National Knowledge Infrastructure,Wanfang database and Vip database. All the related literatures were checked on the research type of article,intervention measures,objectives of the studies etc. and only the high quality trials were enrolled. Meanwhile the manually checked references of the included literatures were used as supplementary data. Rev Man 5. 3 software provided by Cochrane collaboration was used for meta-analysis. The efficacy and safety of the topical administration of TXA in THA were assessed according to results of meta analysis. Results Eleven high-quality literatures including3 092 patients were chosen for the meta-analysis eventually. Meta-analysis results demonstrated that compared with the control group,topical TXA administration significantly decreased the total blood loss[MD =-333. 93,95% CI（-425. 91,-241. 96）,P 0. 01 ],postoperative drainage loss [MD =-167. 27,95% CI（-223. 34,-111. 21）,P 0. 01 ],postoperative hemoglobin drop [MD =-11. 58,95% CI（-13. 47,-9. 69）,P 0. 01 ],and diminished allogeneic transfusion rate [OR =0. 33,95% CI（ 0. 25,0. 43）,P 0. 01 ] and amounts of blood transfusion [OR =-80. 50,95% CI（-150. 65,-10. 35）,P 0. 05 ] in the patients undergoing THA. But there was no significant difference in the incidence of deep vein thrombosis and pulmonary embolism between the TXA-treated group and the control group. Conclusion Topical TXA administration could significantly diminish blood loss,transfusion rate and amounts of blood transfusion in patients undergoing THA without increasing the risk of incidence of venous thromboembolism,and represent favourable efficacy and safety in THA.