氨甲环酸在创伤救治中的应用现状与展望  

The application status and prospect of tranexamic acid in trauma management

作　　者：罗小敏[1] 杨卫泽[1] Luo Xiaomin;Yang Weize(Department of Emergency Medicine,Eastern Campus,Renmin Hospital of Wuhan University,Wuhan 430000,China)

机构地区：[1]武汉大学人民医院东院急诊科,武汉430000

出　　处：《创伤外科杂志》2021年第12期952-954,958,共4页Journal of Traumatic Surgery

摘　　要：创伤性凝血病和过度炎症导致的多器官功能障碍综合征是严重创伤危及患者生命的重要因素。氨甲环酸(TXA)是一种人工合成抗纤溶药物,兼具抗纤溶、抗炎、免疫调节及减轻血管内皮损伤等多重作用。TXA给药方式灵活,除静脉途径外,还可以口服、创伤局部使用或肌肉注射。多部国内外专家共识或指南均建议创伤后3h内应用TXA以降低创伤出血所致的病死率,推荐用法为10min内给予1g负荷量静脉输注,随后8h给予1g维持量。时间窗内使用TXA是创伤救治策略的重要一环。Traumatic coagulopathy and multiple organ dysfunction syndrome caused by excessive inflammation are vital threats to the lives of patients with severe trauma.Besides the anti-fibrinolytic effect,tranexamic acid(TXA)has multiple beneficial effects in trauma cases,including anti-inflammation,immunomodulation and alleviating endothelial injury.TXA can be administered flexibly.In addition to intravenous infusion,TXA can also be administered orally,in wound area or by intramuscular injection.Some expert consensus or guidelines suggest the application of TXA within 3 hours after trauma to reduce the mortality caused by bleeding.The recommendation is that TXA be administered at a loading dose of 1g infused intravenously over 10 minutes,followed by an infusion of 1g over 8 hours.The application of TXA in the time window should be an essential component of cluster strategy for trauma management.

关 键 词：创伤 出血 氨甲环酸 抗纤溶剂 

分 类 号：R641[医药卫生—外科学]