小儿肺出血的局部肺内血静疗法:系统性审查和元分析
Hind A Bafaqih1, Huda M Zarie2, Adnan B Alkurdi1
1Pediatric Critical Care, Prince Sultan Military Medical City, Riyadh, SAU.
Cureus
|February 23, 2026
概括
使用特兰胺酸 (TXA) 或复合激活因子VII (rFVIIa) 的局部肺内疗法显示了儿科肺出血的高出血控制率. 这些向治疗似乎对重症儿童是安全的,因此需要进一步的多中心研究.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 肺部医学 肺部医学
- 血液学 血液学 血液学
背景情况:
- 儿科肺出血是一种严重的,危及生命的疾病,死亡率高.
- 目前的治疗主要是支持性,全身静血药物带来血栓形成的风险.
- 局部肺内疗法提供有针对性的出血控制与减少全身暴露.
研究的目的:
- 系统地审查和元分析局部肺内松酸 (TXA) 和重组激活因子VII (rFVIIa) 对儿科肺出血的疗效和安全性.
- 综合这些针对儿童的定向静血策略的碎片证据.
主要方法:
- 按照PRISMA 2020指南进行系统审查和元分析.
- 搜索了一些主要的数据库 (PubMed/MEDLINE,Embase,Scopus,科学网,科克兰图书馆).
- 包括儿科患者 (0-18岁) 肺出血治疗局部肺内TXA,rFVIIa或组合治疗的研究;主要结局是血液控制和安全.
主要成果:
- 包括6项涉及111名患者的研究;5项经过了定量合成.
- 血流控制率:基于TXA的治疗 (中等异质性) 的86.6%和rFVIIa的82.5% (低异质性).
- 治疗方法之间没有显著差异;即使在高危子组中,也没有发现一致的血栓栓塞并发症.
结论:
- 局部肺内TXA和rFVIIa显示出高的出血控制率,并且作为儿科肺出血的辅助疗法似乎是安全的.
- 这些有针对性的策略对重症儿童来说是有希望的.
- 未来的多中心研究对于优化患者选择,剂量和定义它们在管理算法中的作用至关重要.
更多相关视频
08:27A New Hybrid Quantitative Evaluation Model for Axillary Junctional Hemorrhage in Swine
Published on: December 6, 2024
697
06:15Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
52.3K
相关概念视频
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
533
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
533
01:29Venous Thrombosis III: Interprofessional Care
399
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
399
01:26Flail Chest-II
717
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
717
01:27Pulmonary Embolism III: Nursing Management
498
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
498
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
2.1K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.1K