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氨甲环酸治疗难治性慢性输血依赖性胃肠道血管发育异常出血

Tranexamic acid in treatment-resistant chronic transfusion-dependent gastrointestinal angiodysplasia bleeding.

作者信息

Grooteman Karina V, van Geenen Erwin J M, Drenth Joost P H

机构信息

Gastroenterology and Hepatology, Radboudumc, Nijmegen, Netherlands.

出版信息

BMJ Case Rep. 2017 Nov 1;2017:bcr-2017-221832. doi: 10.1136/bcr-2017-221832.

DOI:10.1136/bcr-2017-221832
PMID:29092972
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5695428/
Abstract

A small proportion of gastrointestinal angiodysplasia bleeding leads to chronic blood cell transfusion dependency. There are no guidelines supporting decision-making among various treatments in patients with gastrointestinal angiodysplasia bleeding. When endoscopic argon plasma coagulation is ineffective, the angiogenesis inhibitors thalidomide and octreotide can be considered. We describe a 77-year-old woman who had side effects of these angiogenesis inhibitors, which caused her to have continued bleeding. She was successfully treated with tranexamic acid with a substantial decrease in need for red blood cell transfusions.

摘要

一小部分胃肠道血管发育异常出血会导致慢性血细胞输血依赖。对于胃肠道血管发育异常出血患者,在各种治疗方法之间进行决策时,目前尚无相关指南支持。当内镜下氩离子凝固术无效时,可以考虑使用血管生成抑制剂沙利度胺和奥曲肽。我们描述了一名77岁女性,她出现了这些血管生成抑制剂的副作用,导致持续出血。她通过氨甲环酸成功治疗,红细胞输血需求大幅减少。

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Tranexamic acid in treatment-resistant chronic transfusion-dependent gastrointestinal angiodysplasia bleeding.氨甲环酸治疗难治性慢性输血依赖性胃肠道血管发育异常出血
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Successful treatment of bleeding from colonic angiodysplasias with tranexamic acid in a hemodialysis patient.氨甲环酸成功治疗血液透析患者的结肠血管发育异常出血
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Thalidomide for refractory gastrointestinal bleeding from vascular malformations in patients with significant comorbidities.沙利度胺用于患有严重合并症的患者因血管畸形引起的难治性胃肠道出血。
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本文引用的文献

1
The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition.《欧洲创伤后大出血和凝血功能障碍管理指南:第四版》
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Medical and endoscopic therapies for angiodysplasia and gastric antral vascular ectasia: a systematic review.血管发育不良和胃窦血管扩张的医学和内镜治疗:系统评价。
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Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.氨甲环酸对创伤伴大出血患者死亡、血管阻塞性事件和输血的影响(CRASH-2):一项随机、安慰剂对照试验。
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Increased plasma fibrinolytic activity in bleeding gastrointestinal angiodysplasia.出血性胃肠道血管发育异常时血浆纤维蛋白溶解活性增加。
Eur J Gastroenterol Hepatol. 2005 Feb;17(2):199-205. doi: 10.1097/00042737-200502000-00011.
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Increased expression of angiogenic factors in human colonic angiodysplasia.人类结肠血管发育异常中血管生成因子表达增加。
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9
Successful treatment of bleeding from colonic angiodysplasias with tranexamic acid in a hemodialysis patient.氨甲环酸成功治疗血液透析患者的结肠血管发育异常出血
Am J Kidney Dis. 1998 Mar;31(3):536-8. doi: 10.1053/ajkd.1998.v31.pm9506694.
10
Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people.健康无症状人群中结肠血管发育异常的患病率及自然病史。
Am J Gastroenterol. 1995 Apr;90(4):564-7.