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Tranexamic acid在急診醫學之應用

摘要


Tranexamic acid在臨床上廣泛使用於各種出血症狀的病人,在急診有外傷性出血、顱內出血、流鼻血、咳血、腸胃道出血、痔瘡出血等不同嚴重程度的出血,tranexamic acid在以上各種情境的證據等級不同,本文主要目的在於探討tranexamic acid在急診常見的各類型出血的實證依據,並給予相關臨床處置之建議,幫助醫師可以快速在臨床上為病人止血並幫助預後改善。

參考文獻


CRASH-2 trial collaborators, Shakur H, Roberts I, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet 2010;376:23-32.
CRASH-2 trial collaborators. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet 2011;377:1096-101.
Michael M. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Lancet 2019;394:1713-23.
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Sprigg N, Flaherty K, Appleton JP, et al. Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet 2018;391:2107-15.

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