氨甲环酸在患儿围术期血液保护作用的研究进展  

Research progress on the blood-protective effects of tranexamic acid in the pediatric perioperative period

作　　者：易祖港 杨璐逢 胡一[1] 陈芳[1] YI Zugang;YANG Lufeng;HU Yi;CHEN Fang(Department of Anesthesiology,Shenzhen Children s Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市儿童医院麻醉科,518000

出　　处：《临床麻醉学杂志》2023年第11期1197-1201,共5页Journal of Clinical Anesthesiology

基　　金：深圳市科技计划项目(JCYJ20220530155613030)。

摘　　要：围术期出血和血液制品的输注会升高患者并发症的发生率和死亡率。优化血液管理策略可以降低围术期风险、改善预后及减少医疗成本。预防性使用氨甲环酸(TXA)是围术期患者血液管理(PBM)策略的重要组成部分。TXA是一种抗纤维蛋白溶解药,竞争性抑制纤溶酶原的激活,可减少手术或创伤出血,进而减少围术期输血量,已广泛应用在成人的各类手术中。在患儿围术期使用TXA的经验多数来源于成人数据,TXA在患儿中的药代动力学研究数量较少,TXA精准使用策略未完全明确。本文着眼于患儿,从TXA的药理学特性、在患儿围术期应用的方法及不良反应等几个方面进行综述,为如何在患儿围术期血液保护中使用TXA并减少其并发症提供参考。Perioperative bleeding and blood product transfusion can increase the incidence of complications and mortality in patients.Optimizing blood management strategies can reduce perioperative risks,improve outcomes,and reduce healthcare costs.Prophylactic use of tranexamic acid(TXA)is an important component of perioperative blood management(PBM)strategies.TXA is an antifibrinolytic agent that competitively inhibits the activation of plasminogen,reducing surgical or traumatic bleeding and subsequently the amount of transfused blood during the perioperative period.It has been widely used in various types of surgeries in adults.However,experience in using TXA in the perioperative period in children is mostly based on adult data,and there are fewer pharmacokinetic studies on the use of TXA in children.The precise use of TXA in children has not yet been fully clarified.This article focuses on children and provides a review of TXA s pharmacological properties,methods of use in the perioperative period in children,and adverse reactions.It aims to provide guidance on how to use TXA in perioperative blood protection in children and reduce its complications.

关 键 词：氨甲环酸 儿童 血液保护 输血 不良反应 

分 类 号：R726.1[医药卫生—儿科]