摘要
目的探讨血凝酶用于多发性创伤患者院前急救的价值。方法选取2019年4月至2022年4月北京急救中心收治的104例多发性创伤患者作为研究对象,根据患者是否应用血凝酶分为观察组(常规院前急救并应用血凝酶治疗,n=52)与对照组(常规院前急救治疗,n=52)。比较2组患者的止血时间、平均出血量、单位面积出血,比较2组患者治疗前后的血红蛋白(Hb)、红细胞压积(HCT)、血小板聚集率(PAR)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、抗凝血酶Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制剂-1(PAI-1),比较2组患者的并发症、不良反应。结果观察组止血时间、平均出血量、单位面积出血均少于对照组(P<0.05);治疗后2组Hb、HCT、PAR水平低于治疗前,观察组高于对照组(P<0.05);2组患者治疗前后,PT、APTT、FIB、D-D、PAI-1、AT-Ⅲ、t-PA水平比较差异无统计学意义(P>0.05)。治疗后,2组患者并发症总发生率比较差异无统计学意义(P>0.05),观察组病死率低于对照组(P<0.05);观察组不良反应发生率为5.77%,对照组不良反应发生率为0,差异无统计学意义(χ^(2)=3.089,P=0.079)。结论多发性创伤患者院前急救应用血凝酶可减少出血量,对患者的凝血和纤维蛋白溶解功能无影响,安全性良好,有利于患者预后的改善。
Objective To explore the value of hemocoagulase in pre⁃hospital care for patients with multiple trauma.Methods A total of 104 patients with multiple trauma admitted to Beijing Emergency Medical Center from April 2019 to April 2022 were selected as study objects.They were divided into observation group(n=52,routine pre⁃hospital emergency treatment with hemocoagulase)and control group(n=52,routine pre⁃hospital emergency treatment).The hemostatic time,average blood loss,unit area bleeding,hemoglobin(Hb),hematocrit(HCT),platelet aggregation rate(PAR),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D⁃dimer(D⁃D),antithrombinⅢ(AT⁃Ⅲ),tissue plasminogen activator(t⁃PA),plasminogen activator inhibitor⁃1(PAI⁃1),complications,and adverse reactions were compared between the two groups.Results The hemostatic time,average blood loss,and unit area bleeding in the observation group were significantly less than those in the control group(P<0.05).The Hb,HCT,and PAR after treatment were significantly lower than those before treatment in the two groups,but the Hb,HCT and PAR after treatment in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in PT,APTT,FIB,D⁃D,PAI⁃1,AT⁃Ⅲ,or t⁃PA between the two groups before and after treatment(P>0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The mortality rate of the observation group was significantly lower than that of the control group(P<0.05).The incidence of adverse reactions was 5.77%in the observation group and 0 in the control group(χ^(2)=3.089,P=0.079).Conclusion The application of hemocoagulase in pre⁃hospital emergency treatment in patients with multiple trauma can reduce bleeding,and has no significant impact on the coagulation and fibrinolysis.It had good safety and is conducive to the improvement of prognosis.
作者
王坤
冯迟
李斗
严浩
Wang Kun;Feng Chi;Li Dou;Yan Hao(Xicheng Emergency Center Station,Beijing Emergency Medical Center,Beijing 100031,China)
出处
《海军医学杂志》
2024年第2期146-150,共5页
Journal of Navy Medicine
关键词
血凝酶
多发性创伤
院前急救
转归
凝血功能
Hemocoagulase
Multiple trauma
Pre⁃hospital care
Outcome
Coagulation function
