Moharamzadeh Payman, Ojaghihaghighi Seyedhossein, Amjadi Mohsen, Rahmani Farzad, Farjamnia Arezoo
Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran.
Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Am J Emerg Med. 2017 Dec;35(12):1922-1925. doi: 10.1016/j.ajem.2017.09.012. Epub 2017 Sep 9.
Local forms of the tranexamic acid have been effective in treating many haemorrhagic cases. So that the aim of the current study is to assess the effectiveness of local tranexamic acid in controlling painless hematuria in patients referred to the emergency department.
This is a randomized, double-blind clinical trial study, which was conducted on 50 patients with complaints of painless lower urinary tract bleeding during June 2014 and August 2015. The patients were randomly divided into two groups of 25 people each, one group receiving tranexamic acid and the other given a placebo. During bladder irrigation, local tranexamic acid and the placebo were injected into the bladder via Foley catheter. Patients were examined over 24h in terms of the amount of normal saline serum used for irrigation, level of hemoglobin, and blood in urine.
In this study it was observed that consumption of tranexamic acid significantly decreased the volume of used serum for bladder irrigation (P=0.041) and the microscopic status of urine decreased significantly in terms of the hematuria after 24h (P=0.026). However, the rate of packed cell transfusion and drop in hemoglobin levels showed no significant difference in both groups of patients (P˃0.05).
The results of this study showed that tranexamic acid could significantly reduce the volume of required serum for bladder irrigation to clear urine, but it had no significant effect on the drop in serum hemoglobin levels.
氨甲环酸的局部应用形式已有效治疗了许多出血病例。因此,本研究的目的是评估局部应用氨甲环酸对急诊科收治患者无痛性血尿的控制效果。
这是一项随机、双盲临床试验研究,于2014年6月至2015年8月对50例主诉无痛性下尿路出血的患者进行。患者被随机分为两组,每组25人,一组接受氨甲环酸治疗,另一组给予安慰剂。在膀胱冲洗过程中,通过Foley导管将局部用氨甲环酸和安慰剂注入膀胱。在24小时内对患者进行检查,观察用于冲洗的生理盐水用量、血红蛋白水平和尿液中的血液情况。
在本研究中观察到,氨甲环酸的使用显著减少了膀胱冲洗所用血清的量(P=0.041),并且24小时后血尿方面的尿液显微镜检查状况显著改善(P=0.026)。然而,两组患者的红细胞压积输血率和血红蛋白水平下降率均无显著差异(P>0.05)。
本研究结果表明,氨甲环酸可显著减少膀胱冲洗清除尿液所需的血清量,但对血清血红蛋白水平的下降无显著影响。