重组人凝血因子Ⅶa对创伤性大出血的疗效观察  

Curative effect of recombinant activated factor Ⅶa in treating patients with traumatic bleeding

作　　者：李俊英[1] 梁宗安[2] 董芸[1] 周平[1] 陈友岱[1] 章晓红[1] 苏明华[1] 

机构地区：[1]四川省医学科学院.四川省人民医院急救中心EICU,四川成都610072 [2]四川大学华西医院呼吸内科,四川成都610041

出　　处：《实用医院临床杂志》2016年第6期45-47,共3页Practical Journal of Clinical Medicine

摘　　要：目的观察重组人凝血因子Ⅶa(r FⅦa)治疗创伤性大出血的临床疗效。方法将2012年9月至2015年9月收治的130例创伤性大出血患者,根据随机数字表法分为2组各65例。对照组给予常规药物止血治疗;观察组除给常规止血药物外,加用r FⅦa治疗,比较两组患者用药前及用药后1、2、4、8、24小时凝血酶原时间(PT)、部分凝血活酶时间(APTT)、血浆纤维蛋白原(FIB)、输血量、多巴胺用量、多器官功能障碍综合征发生率及病死率。结果观察组使用r FⅦa后1小时部分凝血活酶时间缩短;2、4、8、24小时PT、APTT降低;FIB在用药后2、4、8小时升高,差异有统计学意义(P<0.05);总输血量及多巴胺用量均较对照组减少,差异有统计学意义(P<0.05);多器官功能不全发生率降低、在ICU住院期间死亡人数减少。结论在创伤导致严重大出血时,使用重组人凝血因子Ⅶa能加强控制出血,减少并发症的发生,改善预后。Objective To investigate the effects of recombinant activated factorⅦa （ rFⅦa） on patients with traumatic bleed-ing.Methods One hundred and thirty patients with traumatic massive hemorrhage treated between September 2012 and September 2015 were randomly divided into control and observation groups,65 in each group.The control group received conventional hemostatics to stop bleeding while the observe group received rFⅦa treatment in addition to conventional methods.The blood coagulation indicators including prothrombin time （PT）,activated partial thromboplastin time （APTT） and plasma fibrinogen （FIB） were compared before and after 1 h,2 hs,4 hs,8 hs and 24 hs of treatment between the two groups.The blood transfusion volume,dosage of dopamine,inci-dence of multiple organ dysfunction syndrome and mortality were also compared between the two groups.Results In the observation group,APTT was shortened after 1 h of treatment,PT and APTT were decreased after 2 hs,4 hs,8 hs and 24 hs of treatment,and FIB was improved after 2 hs,4 hs and 8 hs of treatment when compared to the control group （ P〈0.05） .Compared with the control group,vol-ume of blood transfusion and dosage of dopamine were decreased significantly（P〈0.05）.The incidence of multiple organ dysfunction syndrome and mortality in ICU were reduced in the observation group when compared to the control group.Conclusion Application of rFⅦa on patients with traumatic massive haemorrhage can strengthen the control of bleeding,reduce the hemorrhagic complication and improve the prognosis.

关 键 词：重组人凝血因子Ⅶa 创伤性出血 凝血酶原时间 部分凝血活酶时间 血浆纤维蛋白原 

分 类 号：R605.972[医药卫生—急诊医学]