摘要
目的分析血必净注射液联合低分子肝素对创伤性弥散性血管内凝血的临床效果和用药安全性。方法选取上海市浦东新区人民医院2017年3月至2018年11月收治的68例创伤性弥散性血管内凝血患者作为前瞻性研究对象,随机分为两组,观察组34例,对照组34例。观察组患者使用血必净注射液联合低分子肝素治疗,对照组患者单纯使用低分子肝素治疗。实时监测并记录两组患者治疗前后的凝血酶时间(TT),活化部分凝血活酶时间(APTT),凝血酶原时间(PT),血小板计数(PLT),D-二聚体(D-D),纤维蛋白原(FIB)和纤维蛋白原定量(Fg)等指标,统计治疗28d后两组患者的治愈率、病死率、出血发生率及其他不良反应发生率等数据并进行对比分析。结果 7 d后,两组的凝血酶时间,活化部分凝血活酶时间,凝血酶原时间,血小板计数,D-二聚体,纤维蛋白原和纤维蛋白原定量均明显改善,与治疗前相比差异具有统计学意义(P <0. 05),但观察组的改善幅度显著优于对照组,差异具有统计学意义(P <0. 05);治疗28 d后,观察组的治愈率82. 4%明显高于对照组61. 8%,病死率(5. 9%)、出血发生率(5. 9%)及其他不良反应发生率(0)明显低于对照组(29. 4%、23. 5%、11. 8%),差异具有统计学意义(P <0. 05)。结论血必净注射液联合低分子肝素对创伤性弥散性血管内凝血具有很强的抗凝作用,治疗效果显著,并发症少,兼具了临床有效性和安全性。
Objective To analyze the clinical effect and safety of Xuebijing injection combined with low molecular weight heparin on traumatic disseminated intravascular coagulation. Methods 68 patients with traumatic disseminated intravascular coagulation admitted to our hospital from March 2017 to November 2018 were randomly divided into two groups, including observation group (34 cases) and control group (34 cases). The patients in the observation group were treated with Xuebijing injection combined with low molecular weight heparin, while those in the control group were treated with low molecular weight heparin alone. The thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin time (PT), platelet count (PLT), D-dimer (D-D), fibrinogen (FIB) and fibrinogen quantification (Fg) before and after treatment were monitored and recorded in real time, and to count up the cure rate, mortality rate, bleeding rate and other adverse reactions of the two groups after 28 days of treatment, then make a comparative analysis. Results After 7 days of treatment, the indexes of thrombin time, activated partial thromboplastin time, prothrombin time, platelet count, D-dimer, fibrinogen and fibrinogen quantification in the two groups were significantly improved compared with those before treatment ( P <0.05), but the improvement extent in the observation group was significantly higher than that in the control group ( P <0.05). After 28 days of treatment, the cure rate of the observation group (82.4%) was significantly higher than that of the control group (61.8%), and the mortality rate, the incidence of bleeding and other adverse reactions of that were significantly lower than those of the control group (5.9%, 5.9%, 0 vs. 29.4%, 23.5%, 11.8%)( P <0.05). Conclusion Xuebijing injection combined with low molecular weight heparin has a strong anticoagulant effect on traumatic disseminated intravascular coagulation, with remarkable therapeutic effect and fewer complications, which has both clinical safety and effectiveness.
作者
钟斐
万健
杨瑞霞
宋熙
张黔
孙杰
诸海军
陈嵩
樊聪慧
ZHONG Fei;WAN Jian;YANG Rui-xia(Shanghai Pudong New Area People's Hospital,Shanghai 201299,China;Department of Pharmacy,The Second Affiliated Hospital of Xi'an Medical College,Xi'an Shaanxi 710000,China.)
出处
《临床和实验医学杂志》
2019年第17期1858-1861,共4页
Journal of Clinical and Experimental Medicine
基金
上海市浦东新区卫生系统领先人才培养计划项目(编号:PWRl2018-08)
关键词
创伤性弥散性血管内凝血
血必净注射液
低分子肝素
安全性
Traumatic disseminated intravascular coagulation
Xuebijing injection
Low molecular weight heparin
Safety
