德斯莫普林减少周围手术出血和输血:一个系统性审查和元分析
Carol Wang1, Victoria Lebedeva2, Jeffy Yang3
1Department of Medicine, Western University, London, ON, Canada.
Perioperative medicine (London, England)
|January 23, 2024
概括
周围的程序性德斯莫普林可能会减少血液损失和输血单位,但会增加低血压风险. 胺酸可能更有效,需要进一步的研究,特别是在患有脏疾病的患者中.
科学领域:
- 麻醉学和外科手术期间的医学.
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 周围的程序性德斯莫普林素用于管理没有遗传性出血障碍的患者的出血.
- 以前的审查没有全面评估最近的证据.
研究的目的:
- 系统地审查术前德斯莫普林素对出血和输血结果的影响.
- 为了比较德斯莫普拉辛与特兰胺酸,并评估安全问题.
主要方法:
- 系统综述和对63项随机对照试验 (4163名参与者) 的元分析,这些试验在2023年2月1日之前发表.
- 包括心脏手术,非心脏手术和非手术手术.
- 评估红细胞输血,再手术,失血和低血压的风险.
主要成果:
- 德斯莫普林可能不会降低输血风险或重新手术率,但可以显著降低输血单位和总血液损失.
- 德斯摩普林素增加了临床显著低血压的风险.
- 在降低输血风险和血液损失方面,特兰克萨姆酸似乎比德斯莫普林素更有效.
结论:
- 德斯莫普林可以减少周围手术流失的血液和输血需求,但随着低血压的风险增加.
- 特兰胺酸在减少出血和输血需求方面显示出更大的有效性.
- 进一步进行大规模试验是有必要的,以评估德斯莫素,特别是在晚期病患者和与特兰胺酸相比.
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