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创伤患者是否均应使用抗纤维蛋白溶解药物?

Should antifibrinolytics be given in all patients with trauma?

机构信息

Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Curr Opin Anaesthesiol. 2012 Jun;25(3):385-8. doi: 10.1097/ACO.0b013e3283532b29.

DOI:10.1097/ACO.0b013e3283532b29
PMID:22459985
Abstract

PURPOSE OF REVIEW

Hemorrhage is the second most important cause of death in patients with trauma, contributing to approximately 30% of trauma-related mortality. Pharmacological prohemostatic agents may be useful adjunctive treatment options in patients with severe blood loss.

RECENT FINDINGS

Tranexamic acid was evaluated in a large international randomized controlled study in patients with trauma and severe blood loss. The drug was shown to reduce death due to bleeding, provided the treatment was given within 3 h after injury. Tranexamic acid treatment did not result in serious adverse events nor thrombotic complications.

SUMMARY

In view of this efficacy and safety of this relatively cheap and simple drug, it may be recommended to put tranexamic acid in the first (maybe even prehospital) line of management of patients with severe traumatic hemorrhage.

摘要

目的综述

出血是创伤患者死亡的第二大主要原因,约占创伤相关死亡的 30%。对于严重失血的患者,药物止血剂可能是有用的辅助治疗选择。

最近的发现

在一项大型国际随机对照研究中,评估了氨甲环酸在创伤和严重失血患者中的作用。结果表明,该药物可降低因出血导致的死亡,前提是在损伤后 3 小时内给予治疗。氨甲环酸治疗未导致严重不良事件或血栓并发症。

总结

鉴于这种药物相对便宜且使用简单,疗效和安全性良好,因此,对于严重创伤性出血的患者,氨甲环酸可被推荐用于一线(甚至是院前)治疗。

相似文献

1
Should antifibrinolytics be given in all patients with trauma?创伤患者是否均应使用抗纤维蛋白溶解药物?
Curr Opin Anaesthesiol. 2012 Jun;25(3):385-8. doi: 10.1097/ACO.0b013e3283532b29.
2
Tranexamic acid for trauma-related hemorrhage.氨甲环酸用于创伤相关出血
Adv Emerg Nurs J. 2014 Apr-Jun;36(2):123-31; quiz 132-3. doi: 10.1097/TME.0000000000000018.
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Tranexamic acid in remote damage control resuscitation.氨甲环酸在远程损伤控制性复苏中的应用。
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Trauma and severe bleeding. Tranexamic acid within one hour to reduce mortality.创伤与严重出血。一小时内使用氨甲环酸以降低死亡率。
Prescrire Int. 2013 Jul;22(140):189-90.
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Tranexamic acid for trauma.用于创伤的氨甲环酸。
Lancet. 2011 Mar 26;377(9771):1052-4. doi: 10.1016/S0140-6736(11)60396-6.
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Thousands of lives could be saved using tranexamic acid for patients with bleeding trauma.对于出血性创伤患者,使用氨甲环酸可挽救数千人的生命。
Inj Prev. 2011 Jun;17(3):211. doi: 10.1136/injuryprev-2011-040059. Epub 2011 May 5.
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Tranexamic acid for trauma.用于创伤的氨甲环酸。
Lancet. 2010 Sep 25;376(9746):1049; author reply 1050-1. doi: 10.1016/S0140-6736(10)61476-6.
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Tranexamic acid for trauma.用于创伤的氨甲环酸。
Lancet. 2010 Sep 25;376(9746):1050; author reply 1050-1. doi: 10.1016/S0140-6736(10)61478-X.
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Tranexamic acid for trauma patients: a critical review of the literature.氨甲环酸用于创伤患者:文献综述
J Trauma. 2011 Jul;71(1 Suppl):S9-14. doi: 10.1097/TA.0b013e31822114af.
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Adjunct agents for bleeding.出血的辅助药物。
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引用本文的文献

1
Pharmacological adjuncts to stop bleeding: options and effectiveness.止血的药物辅助治疗:选择和效果。
Eur J Trauma Emerg Surg. 2016 Jun;42(3):303-10. doi: 10.1007/s00068-015-0613-x. Epub 2015 Dec 11.
2
Bronchoscopic intratumoral injection of tranexamic acid to prevent excessive bleeding during multiple forceps biopsies of lesions with a high risk of bleeding: a prospective case series.经支气管镜肿瘤内注射氨甲环酸预防高出血风险病变多次活检钳切除时的过度出血:一项前瞻性病例系列研究。
BMC Cancer. 2014 Mar 1;14:143. doi: 10.1186/1471-2407-14-143.