Geist Marcus J P, Kessler Jens, Frankenhauser Susanne, Bardenheuer Hubert J
1 Department of Anesthesiology, Palliative Care Medicine, Heidelberg University Hospital, Heidelberg, Germany.
J Palliat Care. 2017 Apr;32(2):47-48. doi: 10.1177/0825859717731701. Epub 2017 Sep 18.
Persistent bleeding is a common reason for admitting patients with advanced cancer to a palliative care unit. Several reports show a successful therapeutic use of the antifibrinolytic agent tranexamic acid in palliative care patients having hemorrhages. However, it is not administered routinely in severe bleeding situations in palliative care, and general dosing recommendations are unclear.
We report on 3 patients who were treated with tranexamic acid due to symptomatic hemorrhage complicating different malignant processes. Case Management and Outcome: A dosing regimen of 1000 mg intravenous tranexamic acid 3 times a day caused an arrest of bleeding in the reported patients within 2 to 3 days. Having controlled the acute bleeding, we continued with an oral administration of 3000 mg per day as maintenance dose.
The described dosing regimen was effective in controlling the symptomatic bleeding of the reported patients. Further studies are needed to get evidence-based information on the optimal dosing regimen of tranexamic acid and to emphasize its significance in palliative medicine.
持续出血是晚期癌症患者入住姑息治疗病房的常见原因。多项报告显示,抗纤维蛋白溶解剂氨甲环酸在有出血症状的姑息治疗患者中具有成功的治疗用途。然而,在姑息治疗的严重出血情况下,它并未常规使用,且一般给药建议尚不明确。
我们报告了3例因不同恶性疾病并发症状性出血而接受氨甲环酸治疗的患者。病例管理与结果:每天静脉注射1000毫克氨甲环酸,分3次给药,使报告的患者在2至3天内出血停止。在控制急性出血后,我们继续以每天口服3000毫克作为维持剂量。
所描述的给药方案有效地控制了报告患者的症状性出血。需要进一步研究以获得关于氨甲环酸最佳给药方案的循证信息,并强调其在姑息医学中的重要性。