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在入院时服用特兰胺酸不会降低额外囊骨折的输血率或血液损失:双盲随机临床试验
Aaron R Owen1, Chelsea C Boe1, Nicolas P Kuttner1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN; and.
Journal of orthopaedic trauma
|September 26, 2024
概括
这项研究发现,在抵达医院后立即给药特兰胺酸 (TXA) 并没有降低部骨折患者的输血率或血液损失. 在这种患者群体中不建议进行手术前的TXA.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
- 药理学 药理学是指药理学的学科.
背景情况:
- 额外囊性关节骨折与显著的血液损失和高的输血率有关.
- 及时治疗至关重要,以最大限度地减少老年患者患有这些骨折的并发症.
研究的目的:
- 评估即时静脉注射松酸 (TXA) 在减少输血需求,血液损失和额外囊性关节骨折患者的并发症方面的疗效.
- 评估TXA对估计的血液损失和不良事件发生率的影响.
主要方法:
- 一个前性,双盲,随机的临床试验在一级创伤中心进行.
- 128名患有OTA/AO 31-A骨折的患者在呈现时接受了静脉TXA或正常盐水安慰剂.
- 结果包括红细胞输血率,估计的血液损失和90天内的并发症.
主要成果:
- 在TXA和安慰剂组 (27%对31%,P = 0.65) 之间,红细胞输血率没有显著差异.
- 估计的血液损失和主要并发症的发生率,包括静脉血栓栓塞事件,中风,心肌梗塞,再入院和死亡率在两组中都相似.
- 需要输血的接受安慰剂的患者平均获得2.30单位,而TXA队列的1.94单位 (P = 0.55).
结论:
- 在呈现时,静脉注射TXA的立即使用似乎不会降低外囊性关节骨折的老年患者的输血率或血液损失.
- 目前的证据不支持在这种特定的骨折模式和患者群体中常规使用术前TXA.
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