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氨甲环酸用于严重创伤:英格兰西南部的实施与评估

Tranexamic acid in major trauma: implementation and evaluation across South West England.

作者信息

Paudyal Priyamvada, Smith Jason, Robinson Maria, South Adrian, Higginson Ian, Reuben Adam, Shaffee Julian, Black Sarah, Logan Stuart

机构信息

aNational Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula (NIHR PenCLAHRC) bSouth Western Ambulance Service NHS Foundation Trust (SWAST) cEmergency Department, Royal Devon and Exeter NHS Foundation Trust, Exeter dBrighton and Sussex Medical School, Division of Primary Care and Public Health, Brighton eAcademic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Medical Directorate, Joint Medical Command, Birmingham, UK fEmergency Department, Derriford Hospital, Plymouth, UK.

出版信息

Eur J Emerg Med. 2017 Feb;24(1):44-48. doi: 10.1097/MEJ.0000000000000323.

Abstract

OBJECTIVE

To carry out a prospective evaluation of tranexamic acid (TXA) use in trauma patients.

PATIENTS AND METHODS

TXA was introduced to all emergency ambulances and emergency departments in the South West, UK, on 1 December 2011. We carried out a prospective evaluation of TXA use in trauma patients in the South West Peninsula between December 2011 and December 2012. We collected prehospital and hospital data on TXA administration using the Trauma Audit Research Network database. Data on prehospital administration of TXA were cross-checked with the South Western Ambulance Service Trust. Data were analysed using SPSS (version 20).

RESULTS

Altogether, 82 patients were administered TXA during the study period. The median age of the patients was 49 years (IQR 30, 66), and 72% were men. One-third of the patients arrived at hospital by air ambulance. During the first 3 months, administration of TXA was limited to one patient each month receiving the drug. However, an upward trend was observed after June until October 2012, with the increment being more than 10 fold in July, September and October 2012.

CONCLUSION

This is the first study to evaluate the use of TXA in civilian practice in the UK. Our study shows that ambulance service personnel and emergency departments can effectively administer TXA.

摘要

目的

对创伤患者使用氨甲环酸(TXA)进行前瞻性评估。

患者与方法

2011年12月1日起,TXA被引入英国西南部所有的急救救护车和急诊科。我们对2011年12月至2012年12月期间英国西南部半岛创伤患者使用TXA的情况进行了前瞻性评估。我们使用创伤审计研究网络数据库收集了院前和院内TXA给药的数据。TXA院前给药的数据与西南救护车服务信托基金进行了交叉核对。数据使用SPSS(版本20)进行分析。

结果

在研究期间,共有82例患者接受了TXA治疗。患者的中位年龄为49岁(四分位间距30,66),72%为男性。三分之一的患者通过空中救护车抵达医院。在最初的3个月里,TXA的给药每月仅限于1例患者。然而,在2012年6月至10月期间观察到上升趋势,在2012年7月、9月和10月增幅超过10倍。

结论

这是英国第一项评估TXA在临床实践中使用情况的研究。我们的研究表明,救护车服务人员和急诊科能够有效地使用TXA。

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