From the Division of Cardiothoracic Anesthesiology and Critical Care, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina (J.H.L, Q.J.Q.); Institute of Anesthesiology, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, Ruhr-University Bochum, Bochum, Germany (A.K.); Seton Dell Medical School Stroke Institute, Austin, Texas (T.J.M.); and the Department of Medicine, Division of Hematology/Oncology, University of North Carolina, Chapel Hill, North Carolina (N.S.K.).
Anesthesiology. 2018 Mar;128(3):657-670. doi: 10.1097/ALN.0000000000001997.
Fibrinolysis is a physiologic component of hemostasis that functions to limit clot formation. However, after trauma or surgery, excessive fibrinolysis may contribute to coagulopathy, bleeding, and inflammatory responses. Antifibrinolytic agents are increasingly used to reduce bleeding, allogeneic blood administration, and adverse clinical outcomes. Tranexamic acid is the agent most extensively studied and used in most countries. This review will explore the role of fibrinolysis as a pathologic mechanism, review the different pharmacologic agents used to inhibit fibrinolysis, and focus on the role of tranexamic acid as a therapeutic agent to reduce bleeding in patients after surgery and trauma.
纤溶作用是止血生理成分的一部分，其功能是限制血栓形成。然而，在创伤或手术后，过度的纤溶可能会导致凝血障碍、出血和炎症反应。抗纤溶药物越来越多地被用于减少出血、异体输血和不良临床结局。氨甲环酸是研究最广泛和大多数国家使用最广泛的药物。本综述将探讨纤溶作用作为病理机制的作用，回顾用于抑制纤溶的不同药理药物，并重点介绍氨甲环酸作为治疗药物在手术后和创伤后减少出血的作用。
