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氨甲环酸在创伤性脑损伤中的早期和超早期应用:我们长达8年的临床经验。

Early and Ultraearly Administration of Tranexamic Acid in Traumatic Brain Injury: Our 8-Year-Long Clinical Experience.

作者信息

Acar Nurdan, Canakci Mustafa Emin, Bilge Ugur

机构信息

Emergency Department, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.

Family Medicine Department, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.

出版信息

Emerg Med Int. 2020 Sep 18;2020:6593172. doi: 10.1155/2020/6593172. eCollection 2020.

Abstract

INTRODUCTION

The most important result of head trauma, which can develop with a blunt or penetrating mechanism, is traumatic brain injury. Tranexamic acid (TXA) can be used safely in multiple trauma. Recent studies showed that TXA can be useful in management of intracerebral hemorrhage, especially in reducing the amount of bleeding. The TXA given in the first 3 hours has been shown to reduce mortality. The aim of our study was to evaluate the effectiveness of tranexamic acid used in patients with traumatic brain injury.

METHOD

Patients with trauma in the emergency room between January 2012 and January 2020 were screened in this retrospective study. The inclusion criteria were being over the age of 18 years, tranexamic acid administration in the emergency department, and traumatic brain injury on brain computerized tomography (CT) and control CT imaging after 6 hours.

RESULTS

The number of study patients was 51. The median score of GCS was 12.00 (8.00-15.00). Subdural hemorrhage and subarachnoid hemorrhage were the most common findings on brain CT scans. In the group TXA treatment for less than 1 hour, the arrival MAP was low and the pulse was high (=0.022 and =0.030, respectively). All the patients were admitted with multiple trauma. None of the 51 patients had thrombotic complications and died due to head injury.

CONCLUSION

TXA appears to be a safe drug with few side effects in the short term in head injuries. According to our experience, it comes to mind earlier in multiple trauma, especially in head trauma with pelvic trauma.

摘要

引言

头部创伤最重要的后果是创伤性脑损伤,其可由钝性或穿透性机制引发。氨甲环酸(TXA)可安全用于多发伤。近期研究表明,TXA在脑出血的治疗中可能有用,尤其是在减少出血量方面。已证实,在最初3小时内给予TXA可降低死亡率。我们研究的目的是评估氨甲环酸用于创伤性脑损伤患者的有效性。

方法

在这项回顾性研究中,对2012年1月至2020年1月在急诊室就诊的创伤患者进行筛选。纳入标准为年龄超过18岁、在急诊科接受氨甲环酸治疗、脑部计算机断层扫描(CT)显示有创伤性脑损伤且6小时后进行对照CT成像。

结果

研究患者数量为51例。格拉斯哥昏迷量表(GCS)的中位数评分为12.00(8.00 - 15.00)。硬膜下出血和蛛网膜下腔出血是脑部CT扫描中最常见的发现。在TXA治疗时间少于1小时的组中,入院时平均动脉压(MAP)较低且脉搏较高(分别为=0.022和=0.030)。所有患者均因多发伤入院。51例患者中无一例出现血栓形成并发症,也没有因头部损伤死亡。

结论

在头部损伤中,TXA短期内似乎是一种副作用较少的安全药物。根据我们的经验,在多发伤中,尤其是伴有骨盆创伤的头部创伤中,应更早想到使用TXA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a928/7520008/ee511660e206/EMI2020-6593172.001.jpg

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