氨甲环酸在腹壁疝修补术中血清肿减少中的应用进展

Progress in Application of Tranexamic Acid in Reducing Seroma in Abdominal Hernia Repair

摘要: 氨甲环酸(Tranexamic Acid, TXA)作为一种合成抗纤溶药物，通过抑制纤维蛋白溶解过程中的纤维蛋白溶酶原激活，减少出血，近年来在腹壁疝修补术中应用广泛。腹壁疝修补术后血清肿的形成是常见并发症，可能导致患者不适、延长住院时间，甚至需要再次手术处理。氨甲环酸通过减少术中和术后的出血量，降低术后渗出液的产生，从而显著减少血清肿的发生率。此外，氨甲环酸还具有一定的抗炎作用，能够减轻术后炎症反应，进一步减少血清肿的形成。已有研究表明，氨甲环酸在乳腺癌切除术、腹部整形手术等多种外科手术中均表现出良好的止血效果和减少血清肿的作用。在腹壁疝修补术中，尽管相关研究较少，但初步证据显示氨甲环酸在减少术后血清肿方面具有积极作用。未来的研究应进一步探讨氨甲环酸在腹壁疝修补术中的具体机制和最佳使用方案，以期为临床实践提供更为科学的指导。通过合理使用氨甲环酸，可以有效减少术后血清肿的发生，提高手术的安全性和患者的术后恢复质量。

Abstract: Tranexamic acid (TXA), as a synthetic antifibrinolytic drug, has been widely used in abdominal wall herniorrhaphy in recent years by inhibiting plasminogen activation during fibrinolysis and reducing bleeding. Seroma formation following ventral hernia repair is a common complication and may lead to discomfort, prolonged hospitalization, or even require reoperation. Tranexamic acid significantly reduces the incidence of seroma by reducing intraoperative and postoperative bleeding and reducing postoperative exudate production. In addition, tranexamic acid also has a certain anti-inflammatory effect, which can reduce the postoperative inflammatory response and further reduce the formation of seroma. It has been shown that tranexamic acid has shown good hemostatic effect and seroma reduction in various surgical procedures such as breast cancer resection and abdominal plastic surgery. Preliminary evidence suggests a positive effect of tranexamic acid in reducing postoperative seroma in ventral hernia repair, although there are few studies. Future studies should further investigate the specific mechanism and optimal use of tranexamic acid in abdominal wall hernia repair in order to provide more scientific guidance for clinical practice. Rational use of tranexamic acid can effectively reduce the occurrence of postoperative seroma, and improve the safety of surgery and the quality of postoperative recovery of patients.