医院前治疗严重创伤的特兰克萨姆酸
, Russell L Gruen1, Biswadev Mitra1
1From the College of Health and Medicine, Australian National University (R.L.G.), Canberra Health Services (R.L.G.), and Joint Health Command, Australian Defence Force (M.C.R.), Canberra, ACT, the Emergency and Trauma Centre (B.M., P.A.C.) and the Departments of Anaesthesiology and Perioperative Medicine (P.S.M.) and Intensive Care (S.A.B., D.C.G.), Alfred Hospital, the Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine (D.C.G., L.J.M., S.J.N., T.T., P.J.Y.), the School of Public Health and Preventive Medicine (B.M., S.A.B., C.J.M., P.A.C., A.B.F., C.A.M., V.P.), the Australian Centre for Blood Diseases (R.L.M.), and the Central Clinical School (P.S.M.), Monash University, Ambulance Victoria (S.A.B.), and the Department of Critical Care, University of Melbourne (P.J.Y.), Melbourne, Aeromedical Operations, NSW Ambulance, Trauma Service, Royal North Shore Hospital, and Sydney Medical School, University of Sydney, Sydney (B.B.), MedSTAR Emergency Medical Retrieval Services, South Australian Ambulance Service (S.M.M.), and the Emergency Department, Royal Adelaide Hospital (S.M.M.), Adelaide, SA, and Queensland Ambulance Service (S.R.) and the Faculty of Medicine, University of Queensland (M.C.R.), Brisbane - all in Australia; Te Toka Tumai Auckland City Hospital (C.J.M.), Hato Hone St. John, Mt. Wellington (B.D.), and the Department of Paramedicine, Faculty of Health and Environmental Sciences, Auckland University of Technology (B.D., A.H.S.), Auckland, and Medical Research Institute of New Zealand (C.J.M., S.H., P.J.Y.), Wellington Free Ambulance (A.H.S.), and the Intensive Care Unit, Wellington Hospital (P.J.Y.), Wellington - all in New Zealand; Cologne-Merheim Medical Center, Department of Traumatology, Orthopedic Surgery, and Sports Medicine, and the Institute for Research in Operative Medicine, Witten-Herdecke University - both in Cologne, Germany (M.M.).
在重创患者中,医院预先治疗的西胺酸并没有改善生存率与良好的功能. 这项研究发现,与安慰剂相比,六个月后的良好结果没有显著差异.
科学领域:
- 创伤护理 创伤护理
- 紧急医疗 紧急医疗
- 凝血障碍 凝血障碍 凝血障碍
背景情况:
- 严重的创伤可能导致创伤诱导的凝血病.
- 在改善这些患者的治疗结果方面,医院前的松酸的有效性是不确定的.
研究的目的:
- 为了确定是否医院前的三胺酸给药改善了大创伤患者的生存率,并带来了有利的功能结果.
- 评估特兰胺酸对死亡率和功能恢复的影响.
主要方法:
- 随机对照试验涉及患有严重创伤的成年人,有凝血病的风险.
- 干预组接受了特兰胺酸 (1g玻尿酸,然后在8小时内1g);对照组接受了安慰剂.
- 主要结局:在6个月后,存活期与良好的功能结局 (格拉斯哥结局尺度-扩展水平≥5) .
主要成果:
- 在Tranexamic酸和安慰剂组之间6个月后有利的功能结果没有显著差异 (53.7%对比53.5%).
- 特兰胺酸组在28天 (17.3%对21.8%) 和6个月 (19.0%对22.9%) 的死亡率下降趋势,尽管在统计学上不显著.
- 两组之间严重不良事件没有有意义的差异.
结论:
- 在大创伤患者中,医院前的西胺酸,然后进行8小时的输液,并没有改善严重创伤患者的生存率和良好的功能结果.
- 这项研究并未证明对这种特定患者群体和治疗方案的特兰胺酸有任何益处.
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