Abstract：
OBJECTIVE: Acute gastrointestinal bleeding is a common emergency. Tranexamic acid (TXA) reduces clot breakdown by inhibiting the action of plasmin and has been shown to reduce the need for blood transfusion in trauma, surgical procedures, and upper gastrointestinal bleeding. This study examined the efficiency of intravenous TXA in patients with acute lower gastrointestinal bleeding.
METHODS: Eighty-one patients aged >18 years with lower GI hemorrhage, presenting as active rectal bleeding and anemia (hemoglobin lower than 11 g/dL or a decrease of 2 gr/dl from the patient\'s base level), were enrolled in this single center, double blind prospective research. Patients were randomly assigned to receive intravenous TXA or placebo from admission until colonoscopy took place. The need for transfusion of packed red blood cells (PRBC) and number of units was recorded and compared between the two groups.
RESULTS: Eighty-one patients were randomized in this study, thirty-nine in the TXA arm, and forty-two in the placebo arm. Patient characteristics did not differ between the groups. Forty-three out of the 81 patients received blood transfusion; twenty-two were on the placebo arm and twenty-one on the TXA arm (p = 0.89). Twenty-nine patients required 2 or more units, 14 in the TXA arm and 15 in the placebo arm (p = 0.98).
CONCLUSIONS: Intravenous TXA has no significant effect on blood requirement in patients with lower GI bleeding. There was no difference in the consumption of PRBC units among the patients in the placebo and TXA groups. It seems that tranexamic acid has no significant effect on transfusion of PRBC units in lower GI bleeding.
METHODS: Eighty-one patients aged >18 years with lower GI hemorrhage, presenting as active rectal bleeding and anemia (hemoglobin lower than 11 g/dL or a decrease of 2 gr/dl from the patient\'s base level), were enrolled in this single center, double blind prospective research. Patients were randomly assigned to receive intravenous TXA or placebo from admission until colonoscopy took place. The need for transfusion of packed red blood cells (PRBC) and number of units was recorded and compared between the two groups.
RESULTS: Eighty-one patients were randomized in this study, thirty-nine in the TXA arm, and forty-two in the placebo arm. Patient characteristics did not differ between the groups. Forty-three out of the 81 patients received blood transfusion; twenty-two were on the placebo arm and twenty-one on the TXA arm (p = 0.89). Twenty-nine patients required 2 or more units, 14 in the TXA arm and 15 in the placebo arm (p = 0.98).
CONCLUSIONS: Intravenous TXA has no significant effect on blood requirement in patients with lower GI bleeding. There was no difference in the consumption of PRBC units among the patients in the placebo and TXA groups. It seems that tranexamic acid has no significant effect on transfusion of PRBC units in lower GI bleeding.
摘要：
目的：急性消化道出血是常见的急症。氨甲环酸（TXA）通过抑制纤溶酶的作用来减少凝块分解，并已被证明可以减少创伤中输血的需要。外科手术,上消化道出血.这项研究检查了急性下消化道出血患者静脉注射TXA的效率。
方法：81例年龄>18岁的下消化道出血患者，表现为活动性直肠出血和贫血（血红蛋白低于11g/dL或从患者的基本水平降低2gr/dl），被登记在这个单一中心，双盲前瞻性研究。从入院开始，患者被随机分配接受静脉TXA或安慰剂，直到进行结肠镜检查。记录并比较两组之间是否需要输注红细胞（PRBC）和单位数。
结果：本研究中随机抽取了81名患者，TXA手臂上有39个，安慰剂组42名。两组患者的特征没有差异。81例患者中有43例接受了输血；安慰剂组22例，TXA组21例（p=0.89）。29名患者需要2个或更多单位，TXA臂中的14和安慰剂臂中的15(p=0.98)。
结论：静脉TXA对下消化道出血患者的血液需求没有显著影响。安慰剂组和TXA组患者的PRBC单位消耗量没有差异。似乎氨甲环酸对下消化道出血中PRBC单位的输注没有显着影响。
方法：81例年龄>18岁的下消化道出血患者，表现为活动性直肠出血和贫血（血红蛋白低于11g/dL或从患者的基本水平降低2gr/dl），被登记在这个单一中心，双盲前瞻性研究。从入院开始，患者被随机分配接受静脉TXA或安慰剂，直到进行结肠镜检查。记录并比较两组之间是否需要输注红细胞（PRBC）和单位数。
结果：本研究中随机抽取了81名患者，TXA手臂上有39个，安慰剂组42名。两组患者的特征没有差异。81例患者中有43例接受了输血；安慰剂组22例，TXA组21例（p=0.89）。29名患者需要2个或更多单位，TXA臂中的14和安慰剂臂中的15(p=0.98)。
结论：静脉TXA对下消化道出血患者的血液需求没有显著影响。安慰剂组和TXA组患者的PRBC单位消耗量没有差异。似乎氨甲环酸对下消化道出血中PRBC单位的输注没有显着影响。
