摘要
目的：观察早期应用血必净注射液对多发性创伤患者凝血系统的影响。方法：选择急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）〉16分的多发性创伤患者60例，排除伤前有慢性肝病、血液病和凝血功能障碍疾病者。随机分为治疗组和对照组各30例。两组均按多发性创伤常规治疗，包括液体复苏、手术、预防感染、营养支持及必要时呼吸机支持治疗等。治疗组在常规治疗基础上入院第1d起用血必净注射液80ml，静脉点滴，1次／12h，连用7d。分别于入院即刻和入院后第1、3、5、7d测定血小板计数（PLT）、凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、纤维蛋后原（FIB）。结果：治疗组第3d起PT、TT、APTT延长和PLT、FIB下降即有改善，与对照组比差异有显著性意义（P〈O．05），急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）治疗组也有改善，与对照组比菪异有显著性意义（P〈0．05）。结论：早期应用血必净注射液对多发性创伤患者能拮抗炎性递质，降低血液黏稠度，改善微循环，干预血小板活化和微血栓形成，从而稳定凝血系统改善多发性创伤预后。
Objective： observation the influence of early time application Xuebiiing injection treatment in coagulation system of multiple--injury patients. Methods All of 60 cases with multiple trauma as well as APACHE Ⅱ〉1 6 except Chronic Liver Diseasers. blood diseasers and coagulation disorders were randomly divided into a therapeutic group（n=30）and a control group（n=30）. The two groups were all treated with multi--trauma conventional therapy. The only difference was that Xuebijing Injection 80ml was given every 12 hours for 7days to the treatment group from admission day. We determinated the value of PLT,PT,TT,APTT,FIB in the immediate and 1st,3rd,5th,7th after admission. Results PT,TT,APTT,PLT,FIB and APACHE Ⅱ score of the treatment group were significantly different from those of control groupon the 3th day after admission. （all P 〈0.05）. Conclusion：Using Xuebijing injection early in multiple trauma patients can aderse inflammatory mediators, reduce blood clotting,improve microcirculation, inhibit platelet activation, regulate blood coagulation system,as a result it can improve prognosis and quality of life of multiple--injury patients.
关键词
多发性创伤
血必净注射液
凝血系统
影响
Multiple-injury, Xuebijing injection, Blood coagulation system, Effect
