Reducing Blood Loss During Cesarean Myomectomy With Tranexamic Acid (TA)
Reducing Blood Loss During Cesarean Myomectomy With Intravenous Versus Topical Tranexamic Acid: a Double-blinded Randomized Placebo-controlled Trial
研究概览
详细说明
Eligible participants were allocated to one of two groups after induction of anesthesia and immediately prior to the operation and just before skin incision. they received 1-gram tranexamic acid (10 ml) in 100 ml saline infusion or placebo (110 normal salines) by slow intravenous injection at an approximate rate of 1 mL per min. The abdomen was exposed through a midline or Pfannenstiel incision, after skin incision, the subcutaneous fat and abdominal fascia were opened crosswise, and the rectus muscle was opened on the midline. The parietal peritoneum was opened longitudinally to reach the pelvic cavity. Uterus was inspected for a number, location, and shape of myomas and other pelvic organs were inspected for associated pathology. a lower uterine incision will be performed to deliver the baby and Uterine incisions on top of myoma were performed. The incision was performed using monopolar diathermy. Intracapsular enucleation of myomas was performed by gently dissecting between the myoma and the pseudo-capsule. The myoma was grasped by Collins forceps and gently enucleated out.,. Myoma bed was closed by 1 or 2 layers of interrupted vicryl sutures (Vicryl 1-0 polyglactin 910; Egycryl, Taisier CO, Egypt). At the end of the surgery, 1 intraperitoneal suction drain was routinely used in all patients the drains were removed on the second postoperative day unless otherwise indicated. Number and size of myomas were recorded. Myoma size represented the mean size of each myoma. Enucleated myomas were sent to histopathology.
Blood loss estimation Intraoperative blood loss was measured by adding the volume of the contents of the suction bottle and the difference in weight (in grams) between the dry and the soaked operation sheets and towels (1 gram = 1 ml.). Post-operative blood loss was measured through intraperitoneal suction drain which measured every 12 hours and on removing the drain. After that, the total blood loss was calculated by the addition of intraoperative and postoperative blood loss.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Aswan、埃及、81528
- AswanUH
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Aswan、埃及
- AswanUH
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- women who attended the outpatient gynecology clinic, seeking treatment for symptomatic leiomyomas and scheduled to undergo abdominal myomectomy with myoma staging from (3 to 6) according to FIGO staging
Exclusion Criteria:
- Patients undergone vaginal or laparoscopic myomectomy.
- Patients received preoperative embolization or gonadotrophin releasing hormone analog.
- Cervical and broad ligament myoma.
- Patients with cardiac, hepatic, renal or thromboembolic disease
- patients had an allergy to tranexamic acid).
学习计划
研究是如何设计的？
设计细节
- 主要用途：预防
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：四人间
武器和干预
参与者组/臂 |
干预/治疗 |
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安慰剂比较：placebo arm
group receive i/v saline plus irrigation of the myoma bed with normal saline
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in IV tranexamic acid group they received 1-gram tranexamic acid (10 ml) in 100 ml saline infusion or placebo (110 normal saline) by slow intravenous injection at an approximate rate of 1 mL per min.In topical tranexamic acid groupA gauze soaked with 2g tranexamic acid (20 ml) diluted in 100 ml of sodium chloride 0.9% or placebo (120ml of sodium chloride 0.9%.)
used to compress the myoma bed for 5 minutes.
To ensure a sufficiently high concentration, the tranexamic acid was diluted only to a volume sufficient to moisten a large wound surface.
20 ml moisten at least 1500 cm2.
其他名称：
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实验性的：IV tranexamic acid group
group received IV tranexamic 1gm in normal saline
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in IV tranexamic acid group they received 1-gram tranexamic acid (10 ml) in 100 ml saline infusion or placebo (110 normal saline) by slow intravenous injection at an approximate rate of 1 mL per min.In topical tranexamic acid groupA gauze soaked with 2g tranexamic acid (20 ml) diluted in 100 ml of sodium chloride 0.9% or placebo (120ml of sodium chloride 0.9%.)
used to compress the myoma bed for 5 minutes.
To ensure a sufficiently high concentration, the tranexamic acid was diluted only to a volume sufficient to moisten a large wound surface.
20 ml moisten at least 1500 cm2.
其他名称：
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有源比较器：topical tranexamic acid group
group received topical tranexamic 2gm in normal saline
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in IV tranexamic acid group they received 1-gram tranexamic acid (10 ml) in 100 ml saline infusion or placebo (110 normal saline) by slow intravenous injection at an approximate rate of 1 mL per min.In topical tranexamic acid groupA gauze soaked with 2g tranexamic acid (20 ml) diluted in 100 ml of sodium chloride 0.9% or placebo (120ml of sodium chloride 0.9%.)
used to compress the myoma bed for 5 minutes.
To ensure a sufficiently high concentration, the tranexamic acid was diluted only to a volume sufficient to moisten a large wound surface.
20 ml moisten at least 1500 cm2.
其他名称：
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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估计术中失血量 (ml)。
大体时间：术中
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术中失血量是通过吸瓶测量的，以及干燥和浸泡的手术床单和毛巾（1 克 = 1 毫升）之间的重量差异（以克为单位）。
通过腹膜内抽吸引流管测量术后失血量，腹膜内抽吸引流管每 12 小时测量一次，并在移除引流管时测量。
之后，将术中和术后失血量相加计算总失血量。
阴道流血
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术中
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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需要输血
大体时间：术后24小时
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需要输血
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术后24小时
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血红蛋白浓度
大体时间：术后24小时
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术前和术后血红蛋白估计
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术后24小时
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operative time
大体时间：operative time
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operative time
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operative time
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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IV tranexamic acid的临床试验
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University of Ioannina招聘中
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St. Anne's University Hospital Brno, Czech Republic主动，不招人