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临床输血与检验

临床输血与检验 ›› 2016, Vol. 18 ›› Issue (5): 455-458.DOI: 10.3969/j.issn.1671-2587.2016.05.016

• 临床输血研究 • 上一篇    下一篇

早期止凝血管理治疗创伤性凝血病的疗效研究

周跃, 顾怀金   

  1. 235000 安徽省淮北市人民医院
  • 收稿日期:2016-05-15 出版日期:2016-10-20 发布日期:2017-05-19
  • 作者简介:周跃（1970-）,男,安徽淮北人,主管检验师,学士,主要从事临床输血工作,（Tel）18909613812（E-mail）748738682@qq.com。

Early Stage Coagulation Management Benefits the Treatment of Acute Traumatic Coagulopathy

ZHOU Yue, GU Huai-jin   

  1. People's Hospital of Huaibei City in Anhui Province,Huaibei 235000
  • Received:2016-05-15 Online:2016-10-20 Published:2017-05-19

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摘要： 目的 探讨损伤控制复苏（DCR）结合大量输血模式（MTP）治疗创伤性凝血病的临床疗效。方法 选择ICU收治的严重创伤性凝血病患者38例,分为研究组（20例）和对照组（18例）,研究组采用DCR结合MTP的治疗方法,对照组采用传统治疗方法。回顾性分析两组在入院12 h和72 h凝血酶原时间（PT）、国际标准化比值（INR）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、血小板（PLT）的水平。统计入院72 h红细胞（RBC）用量、ICU住院时间、休克纠正率、30 d生存率。结果 与对照组比较,研究组72 h凝血指标明显改善;研究组72 h红细胞用量、ICU住院时间明显低于对照组,休克纠正率、30 d生存率高于对照组（P<0.05）。结论 DCR结合MTP治疗方法对改善凝血功能、抑制大出血、提高患者生存率有较好疗效。

关键词: 早期止凝血管理, 创伤性凝血病, 临床结局

Abstract: Objective To investigate the clinical effect of damage control resuscitation（DCR） scheme combined with massive transfusion pattern (MTP) on acute traumatic coagulopathy. Methods Thirty-eight patients who had severe traumatic coagulopathy in ICU were randomly divided into treatment group (n=20) and control group（n=18）. The patients in treatment group adopted DCR combined with MTP, while control group adopted traditional method. The blood coagulat-ion function was analyzed after 12 h and 72 h by prothrombin time（PT）,international normalized ratio（INR）,acti-vated partial thromboplastin time（APTT）,fibrinogen（FIB）,and platelets. The total amount of RBC during 72 h,the days of hospital ICU stay,the corrected rate of shock,and the 30-day survival rate. Results Compared with the control group,the treatment group showed a quick recovery of blood coagulation function. The total amount of PRBC during 72 h,the days of ICU stay in the treatment group were less than those in control group,while the corrected rate of shock and the 30-day survival rate were higher than those of control group（P<0.05）. Conclusion DCR scheme, combined with MTP program,has a promising effect on blood coagulation improvement,hemostasis,and the survival rate increase of patients.

Key words: Coagulation management in earlier stage, Acute traumatic coagulopaty, Clinical outcome

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