Simmons Jeff, Sikorski Robert A, Pittet Jean-Francois
aAnesthesia Services Division, Trauma Section, UAB Department of Anesthesiology, Birmingham, Alabama bDivision of Trauma Anesthesiology, Department of Anesthesiology, University of Maryland School of Medicine, and Perfusion and Cell Salvage Services, R Adams Cowley Shock Trauma Center, Baltimore, Maryland cCritical Care Division, Department of Anesthesiology, and Surgery and Cell Biology, Center for Lung Injury and Repair, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Curr Opin Anaesthesiol. 2015 Apr;28(2):191-200. doi: 10.1097/ACO.0000000000000165.
Optimizing hemostasis with antifibrinolytics is becoming a common surgical practice. Large clinical studies have demonstrated efficacy and safety of tranexamic acid (TXA) in the trauma population to reduce blood loss and transfusions. Its use in patients without pre-existing coagulopathies is debated, as thromboembolic events are a concern. In this review, perioperative administration of TXA is examined in nontrauma surgical populations. Additionally, risk of thromboembolism, dosing regimens, and timing of dosing are assessed.
Perioperative use of TXA is associated with reduced blood loss and transfusions. Thromboembolic effects do not appear to be increased. However, optimal dosing and timing of TXA administration is still under investigation for nontrauma surgical populations.
As part of a perioperative blood management programme, TXA can be used to help reduce blood loss and mitigate exposure to blood transfusion.
使用抗纤溶药物优化止血正成为一种常见的外科手术操作。大型临床研究已证明氨甲环酸（TXA）在创伤人群中减少失血和输血方面的有效性和安全性。对于无凝血功能障碍患者使用TXA存在争议，因为血栓栓塞事件是一个令人担忧的问题。在本综述中，我们研究了非创伤性手术人群围手术期使用TXA的情况。此外，还评估了血栓栓塞风险、给药方案和给药时间。
围手术期使用TXA与减少失血和输血有关。血栓栓塞效应似乎并未增加。然而，对于非创伤性手术人群，TXA的最佳给药剂量和时间仍在研究中。
作为围手术期血液管理计划的一部分，TXA可用于帮助减少失血并减少输血暴露。
