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目的分析重组人凝血因子Ⅶa在严重创伤合并创伤性凝血病患者中的临床治疗效果。方法严重创伤合并创伤性凝血病患者42例,其中治疗组17例,给予重组人凝血因子Ⅶa治疗,对照组25例。所有患者均按损伤控制原则救治,比较两组患者治疗后的凝血功能指标、总输血量[红细胞(RBC)与新鲜冰冻血浆(FFP)]、ICU住院时间及死亡率。结果治疗组患者的RBC和FFP总输注量分别为(17.13±3.68)U和(15.98±5.13)U,对照组患者分别为(21.42±5.60)U和(20.18±4.57)U,两组比较差异有统计学意义(P<0.05);治疗组患者ICU住院时间和死亡率分别为(4.3±1.6)天和17.6%,对照组患者分别为(5.6±1.8)天和(48.0%),两组比较差异有统计学意义(P<0.05);治疗12小时和24小时后,治疗组凝血酶原时间(PT)、部分凝血活酶时间(APTT)、国际标准化比值(INR)及纤维蛋白原(FIB)指标明显改善,优于对照组(P<0.05或P<0.01)。结论创伤性凝血病患者给予重组人凝血因子Ⅶa,能改善患者的外源性凝血功能,减少输血总量,缩短ICU住院时间,降低死亡率。
Objective To analyze the clinical effect of recombinant human factor Ⅶ a in patients with severe traumatic traumatic coagulopathy. Methods Thirty-two traumatic patients with traumatic coagulopathy were included. Among them, 17 cases were treated with recombinant human coagulation factor Ⅶ a and 25 cases were treated with control group. All patients were treated according to the principle of injury control. The coagulation parameters, total blood transfusion (RBC and fresh frozen plasma (FFP)), ICU length of stay and mortality in the two groups were compared. Results The total amount of RBC and FFP infusion in the treatment group was (17.13 ± 3.68) U and (15.98 ± 5.13) U, respectively, and that in the control group was (21.42 ± 5.60) U and (20.18 ± 4.57) U, respectively (4.3 ± 1.6) days and 17.6% respectively in the treatment group and (5.6 ± 1.8) days and (48.0%) in the control group, respectively. The difference was statistically significant (P0.05) (P <0.05). After 12 hours and 24 hours treatment, the prothrombin time (PT), partial thromboplastin time (APTT), international normalized ratio (INR) and fibrinogen (FIB) index was significantly improved, better than the control group (P <0.05 or P <0.01). Conclusions The administration of recombinant human coagulation factor Ⅶ a to patients with traumatic coagulopathy can improve the extrinsic coagulation function, reduce the total blood transfusion, shorten the ICU hospitalization time and reduce the mortality rate.