氨甲环酸在创伤性脑损伤患者中的应用

Application of tranexamic acid in traumatic brain injury patients

创伤性脑损伤(TBI)后颅内出血很常见,可导致患者发生脑疝甚至死亡。氨甲环酸(TXA)是一种赖氨酸类似物,它竞争性抑制纤溶酶原,抑制纤维蛋白凝块溶解所必需的纤溶酶激活。TXA可以减少颅外大出血的创伤患者因失血而死亡,通过减少颅内出血的扩大来改善TBI患者的预后。全文从TBI对机体的影响、TXA在TBI患者中的应用、TXA相关并发症三个方面,对TXA在TBI患者中的应用做一综述,为指导TBI后不同时间窗内的TXA用药方案、降低TBI并发症发生率提供参考。

Intracranial bleeding is common after traumatic brain injury(TBI)and can cause brain herniation and death.Tranexamic acid(TXA)is a lysine analog that competitively inhibits the activation of plasminogen to plasmin,which is essential for the breakdown of fibrin clot.It has been shown to reduce deaths due to blood loss in trauma patients with significant extracranial bleeding.Tranexamic acid may improve outcomes in patients with intracranial bleeding by reducing the expansion of intracranial hemorrhages.This paper reviews the application of TXA in patients with TBI from three aspects:the effect of TBI on the body,the application of TXA in TBI and TXA-associated complications,so as to provide reference to guide the administration of TXA in different time windows after TBI and reduce the incidence of TBI-related complications.