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张聪.氨甲环酸联合纤维蛋白原对创伤性凝血病患者凝血功能及其预后的影响[J].内科急危重症杂志,2025,31(2):145-148
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| DOI：10.11768/nkjwzzzz20250210 |
| 中文关键词: 氨甲环酸 纤维蛋白原 创伤性凝血病 凝血功能 预后 |
| 英文关键词: |
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| 摘要点击次数: 75 |
| 全文下载次数: 122 |
| 中文摘要: |
| 摘要 目的：探究氨甲环酸联合纤维蛋白原（Fib）对创伤性凝血病（TIC）患者凝血功能及其预后的影响。方法：选取TIC住院患者150例，采用随机数字表法分为对照组和研究组，每组75例。对照组在常规治疗的基础上给予氨甲环酸治疗，研究组在对照组的基础上加用Fib治疗。收集2组患者的临床资料并比较其凝血功能、液体复苏情况、炎症因子的表达变化及其预后。结果：治疗前，2组患者的血小板（PLT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、Fib、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平比较，差异无统计学意义（P均＞0.05）；治疗后，2组患者的PT、APTT、IL-6及TNF-α水平显著降低，Fib、PLT显著升高，且研究组上述指标改善更为明显（P均<0.05）。与对照组比较，研究组患者的晶体液、红细胞悬液、新鲜冰冻血浆、冷沉淀明显降低（P均<0.05）。研究组患者的多器官功能障碍综合征（MODS）发生率、28d病死率、1年病死率显著低于对照组（P均<0.05）。结论：氨甲环酸联合Fib治疗TIC效果确切，可改善患者凝血功能及液体复苏情况，降低炎症因子水平，有助于降低发生MODS的风险，提高患者的生存率。 |
| 英文摘要: |
| Abstract bjective: To investigate the effects of tranexamic acid combined with fibrinogen (Fib) on coagulation function and prognosis in patients with trauma-induced coagulopathy (TIC). Methods: A total of 150 hospitalized patients with TIC were prospectively selected and divided into a control group (75 cases) and a study group (75 cases) by a random number table method. The control group was given tranexamic acid on the basis of conventional treatment, and the study group was treated with Fib on the basis of the control group. Clinical data were collected and the coagulation function, fluid resuscitation, expression of inflammatory factors, and prognosis of the two groups were compared. Results: Before treatment, there was no obvious difference in platelet (PLT) count, prothrombin time (PT), activated partial thromboplastin time (APTT), Fib, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels between the two groups (all P>0.05).After treatment, the levels of PT, APTT, IL-6, and TNF-α in patients with TIC in both groups were obviously decreased , while the levels of Fib and PLT cound were obviously increased, and the above indicators were improved more obviously in the study group (all P<0.05). Compared with the control group, the crystal fluid, red blood cell suspension, fresh frozen plasma, and cold precipitation of patients in the study group were obviously reduced (all P<0.05). The incidence of multiple organ dysfunction syndrome (MODS), 28-day mortality, and one-year mortality in the study group were obviously lower than those in the control group (all P<0.05). Conclusion: The efficacy of tranexamic acid combined with Fib in the treatment of TIC is accurate.Tranexamic acid combined with Fib can improve the coagulation function and fluid resuscitation of patients, reduce the expression level of inflammatory factors, and help to reduce the risk of MODS and improve the survival rate of patients. |
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