Lancet:氨甲环酸用于创伤性脑损伤患者的治疗效果研究

2019-10-15 MedSci MedSci原创

研究认为,氨甲环酸在创伤性脑损伤患者中是安全的,并且在损伤后3小时内治疗可以减少与头部损伤相关的死亡

在创伤性颅外出血患者中,氨甲环酸可减少手术出血,降低死亡率。颅内出血是创伤性脑损伤(TBI)后常见的脑出血症状,可导致脑突出和死亡。近日研究人员评估了氨甲环酸治疗TBI患者的疗效。

研究在29个国家的175家医院开展。颅脑损伤后3h内,格拉斯哥昏迷评分(GCS)低于12分,CT扫描有任何颅内出血,但没有严重颅外出血的患者参与研究。患者随机接受氨甲环酸(1g/10min,然后在8h内注射1g)或安慰剂。研究的主要终点为伤后3小时内接受治疗的患者在伤后28天内因头部损伤在医院死亡。

12737例TBI患者参与研究,随机接受氨甲环酸(6406[50.3%]或安慰剂[6331[49.7%]),其中9202(72.2%)患者在3小时内接受治疗。在3h内治疗的患者中,氨甲环酸组中头部损伤相关死亡的风险为18.5%,安慰剂组为19.8%(855 vs 892起事件;风险比[RR]0.94)。在预先规定的敏感性分析中,在基线时,在GCS评分为3或双侧未反应性瞳孔的患者中,氨甲环酸组颅脑损伤死亡风险为12.5%,安慰剂组14.0%(485 vs 525起事件,RR:0.89)。氨甲环酸降低轻中度颅脑损伤患者头部损伤相关死亡的风险(RR:0.78), 但在重型颅脑损伤患者中无显著效果(0.99),轻度和中度颅脑损伤患者接受早期治疗(3小时内)比晚期更有效,但对重型颅脑损伤患者的治疗时间无明显影响。氨甲环酸和安慰剂组血管闭塞事件的风险相似(RR:0.98,组间癫痫发作风险相似(1.09)。

研究认为,氨甲环酸在创伤性脑损伤患者中是安全的,并且在损伤后3小时内治疗可以减少与头部损伤相关的死亡。

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    2021-07-19 xzmynya

    学习

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    2020-08-28 howi
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    2019-12-16 amyloid
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1000791, encodeId=aa211000e9160, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160531/IMG574DA473DF46C6923.jpg, createdBy=e39768313, createdName=xzmynya, createdTime=Mon Jul 19 09:22:10 CST 2021, time=2021-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830293, encodeId=fb2c18302939e, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Aug 28 01:57:00 CST 2020, time=2020-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894131, encodeId=394c1894131d8, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Mon Mar 02 15:57:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025501, encodeId=65d32025501e7, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Mon Dec 16 07:57:00 CST 2019, time=2019-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335279, encodeId=fc4213352e989, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Thu Oct 17 07:57:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397843, encodeId=05ac139e84332, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Thu Oct 17 07:57:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373991, encodeId=3ba93e399199, content=作用好像不是很大, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cf1c5207418, createdName=147515b1m94暂无昵称, createdTime=Wed Oct 16 13:07:25 CST 2019, time=2019-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032305, encodeId=a4ae1032305b4, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Oct 15 19:57:00 CST 2019, time=2019-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046930, encodeId=b759104693043, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Tue Oct 15 19:57:00 CST 2019, time=2019-10-15, status=1, ipAttribution=)]
    2019-10-16 147515b1m94暂无昵称

    作用好像不是很大

    0

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    2019-10-15 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2019-10-15 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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