Relke Nicole, Chornenki Nicholas L J, Sholzberg Michelle
Department of Medicine Queen's University Kingston ON Canada.
Department of Medicine St. Michael's Hospital University of Toronto Toronto ON Canada.
Res Pract Thromb Haemost. 2021 Jul 14;5(5):e12546. doi: 10.1002/rth2.12546. eCollection 2021 Jul.
Tranexamic acid (TXA) is an antifibrinolytic agent commonly used for the treatment or prevention of bleeding. Indications for TXA are diverse, including heavy menstrual bleeding, trauma, postpartum hemorrhage, traumatic brain injury, and surgical site bleeding. Despite decades of use and a robust body of evidence, hesitancy using TXA persists in many clinical settings. This illustrated review describes the history, pharmacology, and practical considerations of TXA use. We also describe the major landmark randomized controlled trials of TXA and their implications. Finally, we review the evidence around common controversies surrounding TXA such as the risk of thrombosis, prescription along with combined hormonal contraceptives, and use in patients with gross hematuria.
氨甲环酸（TXA）是一种常用于治疗或预防出血的抗纤维蛋白溶解剂。TXA的适应证多种多样，包括月经过多、创伤、产后出血、创伤性脑损伤和手术部位出血。尽管已使用数十年且有大量证据，但在许多临床环境中，使用TXA仍存在犹豫情绪。本图文综述描述了TXA的历史、药理学及实际应用考量。我们还描述了TXA的主要标志性随机对照试验及其意义。最后，我们回顾了围绕TXA的常见争议的相关证据，如血栓形成风险、与复方激素避孕药联合使用以及在肉眼血尿患者中的应用。
