血必净、喜炎平、钠络酮联用对重症胸腹损伤急性凝血功能障碍的疗效分析  

Therapeutic effectiveness analysis of Xuebijing, Xiyanping combined with naloxone in the treatment of acute coagulation disorders during severe thoracoabdominal injuries

作　　者：李志伟[1] 王著军 徐旭[1] 郭雅琼[1] 乔帅[1] 梁永刚[1] 马之嘉[1] 冀蒙[1] 郝莉[1] 宛如[1] 

机构地区：[1]中国人民解放军第二五三医院急诊科,呼和浩特010051 [2]呼和浩特国际机场集团有限公司急救中心,010070

出　　处：《国际中医中药杂志》2014年第3期209-212,共4页International Journal of Traditional Chinese Medicine

摘　　要：目的探讨血必净（xBJ）、喜炎平、钠络酮（Nx）联合应用对重症胸腹损伤急性凝血功能障碍的疗效。方法将2009年1月至2012年6月在呼和浩特第二五三医院急诊科就诊，创伤指数（ffaumaindex，TI）≥17分者纳入，合并颅脑损伤及在急诊死亡的胸腹损伤患者排除。按患者要求及经济承受能力分为两组，治疗组82例、对照组47例；治疗组用药前及用药后分别检查血小板计数（PLT）、血浆D-二聚体（D-D）、部分活化凝血酶原时间（APPT）、凝血酶原时间（PT）、凝血酶时间（TT）；肿瘤坏死因子-α（TNF-Ⅱ）、内毒素（LPS）、白细胞介素．6（IL-6）、磷脂酶A2（PLA2）和血小板活化因子（PAF），对照组仅于用药后进行同项目检查。结果治疗组用药前PLT（83．44±38．52）10^9/L、D．D（1823．89±608．02）U／L、APTT为（68．24±24．12）S、PT为（28．42±10．83）S、TT为（58．27±12．44）S、PLA2（41．35±14．26）nedroa、PAJF（15765．31±4431．65）ng／L：用药后PLT为（127．59±27．18）109／L、D-D为（769．42±106．34）U／L、APTT为（49．11±12．76）S、PT为（19．51±8．23）S、Tr为（31．44±9．17）S、PLA2（19．16±7．11）ng／ml、PAF（6722．56±1049．34）ng／L；对照组用药后PLT为（89．22±31．27）109／L、D。D为（1814．45±643．18）U／L、APTT为（63．48±28．27）S、PT为（27．79±11．94）S、TT为（60．51±14．23）s、PLA2（44．71±16．52）n∥ml、PAF（15933．07±4573．19）ng／L。治疗组用药后PLT升高、D-D、APTT、PT、TT降低；TMF-α、LPS、IL-6、PLA2、PAF表达下降，与同组用药前及对照组比较，差异有统计学意义（P〈0．01）。结论XBJ、喜炎平、NX联合治疗可改善重症胸腹损伤患者的凝血功能障碍，减少并发症，提高生存率。Objective To observe the therapeutic effectiveness of the early intervention of Xuebijing （XBJ） Xiyanping and Naloxone （NX） in acute coagulation disorders during severe thoracoabdominal injuries. Methods Severe thoracoabdominal injury patients with trauma index （TI） ≥17 points except the ones associated craniocerebral injuries and died in emergency department were randomly divided into two groups： a intervention group （n=82） and a control group （n=47） ; The patients were all collected at 253th Hosptital of PLA between January 2009 and June 2012. The intervention group was tested at the time of arriving at the emergency department and the time of leaving the emergency department to the inpatient department for platelet count （PLT）, D-dimer （D-D）, activated partial thromboplastin （APPT）, prothrombin time （PT）, thromboplastin time （TT）, tumor necrosis factor-or （TNF〈t）, lipopolysaccharide （LPS）, interleukin-6 （IL-6）, phospholipase A2 （PLA2） and platelet-activating factor（PAF）. The control group was just tested at the time of leaving the emergency department for the same items. Results At the time of arriving at the emergency department, PLT was （83.44±38.52） 109/L, D-D was （1 823.89±608.02） U/L, APTT was （68.24±24.12） s, PT was （28.42± 10.83） s, TT was （58.27± 12.44） s, PLA2 （41.35 ± 14.26） ng/ml, PAF （ 15 765.31± 4431.65 ） ng/L; At the time of leaving the emergency department, PLT was （127.59 ± 27.18） 109/L, D-D was （769.42 ± 106.34） U/L, APTT was （49.11± 12.76） s, PT was （19.51 ± 8.23） s, TT was （31.44± 9.17） s, PLA2 （ 19.16± 7.11 ） ng/ml, PAF （ 6 722.56 ± 1 049.34） ng/L; At the time of leaving the emergency department the records of the control group of severe thoracoabdominal injury patients, PLT was （89.22 ± 31.27） 109/L, D-D was （1 814.45 ± 643.18） U/L, APTT was （63.48 ± 28.27） s, PT was （27.79± 11.94） s, TT was （60.51 ± 14.23） s, PLA2 （44.71 ±

关 键 词：重症胸腹损伤 急性凝血功能障碍 血必净 喜炎平 钠络酮 救治效果分析 

分 类 号：R561[医药卫生—呼吸系统]