胸前大动脉外科手术中的手术内静血剂-一个范围审查
Maite M T van Haeren1,2, Caitlin Bozic1, Jennifer S Breel1
1Department of Anesthesiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands.
Journal of clinical medicine
|June 13, 2025
概括
对于胸前大动脉手术中的静血剂的证据有限. 抗纤维素解药,第八因子绕活性抑制剂 (FEIBA) 和纤维素原可能有助于出血患者,但需要更多的研究.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 血液学 血液学 血液学
背景情况:
- 开放胸前大动脉手术具有较高的出血并发症率.
- 凝血管理研究往往忽视胸前大动脉手术.
- 本综述评估了这种患者群体的静血剂.
研究的目的:
- 评估当前关于手术内静止血压剂的证据.
- 为了确定它们在胸前大动脉手术中对出血和输血的影响.
- 发现最佳凝血管理的研究缺口.
主要方法:
- 对MEDLINE,Embase和Cochrane图书馆进行范围审查.
- 包括随机对照试验和观察性研究与比较.
- 专注于胸前大动脉手术,不包括特定类型.
主要成果:
- 33项研究分析了抗纤维解药,纤维素,rFVIIa,血液制品和FEIBA.
- 血液制品的证据尚不清楚;FEIBA可能会减少在主动脉剖析中的使用.
- 纤维素原数据是混合的;抗纤维素分解剂显示出潜力,但结果相冲突.
结论:
- 在胸前大动脉手术中使用静血剂的证据有限.
- 抗纤维素解药,FEIBA和纤维素原可能有利于特定出血患者.
- 为了最佳的凝血管理策略,需要高质量的RCT.
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