Schulman S
Department of Haematology, Coagulation Unit, Karolinska Hospital, Stockholm, Sweden.
Haemophilia. 2003 Jul;9(4):368-75. doi: 10.1046/j.1365-2516.2003.00765.x.
There is evidence, albeit scientifically weak, for improved cost/benefit with administration of factor concentrates by continuous infusion when high-dose replacement is necessary, as several studies have shown a reduced requirement for the concentrate. There is evidence from only one study for fewer bleeding complications with continuous infusion. There is evidence from two studies that additional therapy with tranexamic acid reduces the risk of bleeding complications in patients receiving continuous infusion. Future studies should address the question of minimum steady-state levels required for haemostasis, comparisons with bolus injection using a randomized design and investigate the risk of inhibitor formation.
有证据表明，尽管科学性较弱，但在需要大剂量替代治疗时，通过持续输注因子浓缩物可改善成本效益，因为多项研究表明浓缩物的需求量有所减少。仅有一项研究有证据表明持续输注可减少出血并发症。两项研究有证据表明，氨甲环酸辅助治疗可降低接受持续输注患者发生出血并发症的风险。未来的研究应解决止血所需的最低稳态水平问题，采用随机设计与推注法进行比较，并研究抑制剂形成的风险。
