静脉注射的松酸对烧伤手术期间出血的影响:双盲随机临床试验
Mohsen Abaspour Naderi1, Anoush Dehnadi Moghadam2, Mohammadreza Mobayen1
1Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran.
Burns : journal of the International Society for Burn Injuries
|November 10, 2024
概括
特兰胺酸 (TXA) 显著减少严重烧伤手术患者的手术内出血,流体需求和手术室时间. 这种抗纤维解质剂改善了手术结果和住院时间.
科学领域:
- 创伤和烧伤外科手术
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在严重烧伤手术中,手术内流失的血液是一个主要问题,影响患者的发病率和死亡率.
- 作为抗纤维解质剂的特兰胺酸 (TXA) 显示出减轻手术出血的潜力.
研究的目的:
- 评估系统性TXA在重度烧伤患者 (TBSA>20%) 手术期间减少手术内出血的疗效.
- 评估TXA对手术室时间,静脉注射液体需求,住院时间和患者整体结果的影响.
主要方法:
- 这是一项双盲随机临床试验,涉及94名严重烧伤患者.
- 患者被随机分为两组,其中一组在手术期间接受TXA (10 mg/kg加重剂量,然后输注1 mg/kg/h).
主要成果:
- TXA组显示出血液流失 (P=0.043),IV液体体积 (P=0.021),OR时间 (P=0.002) 和住院时间 (P=0.0001) 的显著减少.
- 在TXA组中,需要输血的次数较少 (P=0.024).
- 女性和没有吸入伤害的患者的反应更好;然而,TXA组的移植存活率较低.
结论:
- 在烧伤手术期间静脉注射TXA有效减少出血和相关并发症.
- TXA最大限度地减少了对静脉输液和输血的需求,缩短了手术的持续时间,并改善了整体的手术结果.
- 可能需要进一步的研究来探索观察到的对移植存活的影响.
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