寒冷条件下急性失血模型不同途径输注纤维蛋白原浓缩物差异比较  

Comparison of fibrinogen concentrate of different infusion routes in acute blood loss models under cold condition

作　　者：张贺 田竞 金海 陆辉 ZHANG He;TIAN Jing;JIN Hai;LU Hui(Department of Planning Section of Medical Service,General Hospital of Northern Theater Command;Department of Orthopaedics,General Hospital of Northern Theater Command;Department of Neurosurgery,General Hospital of Northern Theater Command;General Hospital of Northern Theater Command,Shenyang 110840,China)

机构地区：[1]北部战区总医院卫勤部计划科 [2]北部战区总医院骨科 [3]北部战区总医院神经外科 [4]北部战区总医院,辽宁沈阳110840

出　　处：《西北国防医学杂志》2020年第2期78-82,共5页Medical Journal of National Defending Forces in Northwest China

基　　金：“十三五”时期全军军事理论科研计划项目;军队后勤科研计划项目(CLB18L049);军队后勤科研计划项目(CLB18J054);全军军事理论科研计划项目(19LBJ1009B)~~

摘　　要：目的:探讨寒冷条件下急性失血模型不同途径输注纤维蛋白原浓缩物的差异。方法:12只巴马猪随机分为骨内输注(intraosseous,IO)组和静脉输注(intravenous,IV)组,每组6只。建立急性失血模型,控制失血量为35 ml/kg。等量补充乳酸钠林格氏液后输注纤维蛋白原浓缩物80 mg/kg。对比两组麻醉诱导后(T1)、急性失血补液后(T2)、纤维蛋白原浓缩物治疗30 min后(T3)3个时间点的血细胞比容(hematocrit,Hct)、血小板计数(platelet,PLT)、血红蛋白(haemoglobin,Hb)、白细胞计数(white blood cell count,WBC)、凝血酶原时间指数(prothrombin time index,PTI)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、血浆纤维蛋白原浓度,并评估凝血状态。结果:两组在T1、T2、T33个时间点的Hct、Hb、PLT、WBC、PTI、APTT、血浆纤维蛋白原水平比较,差异无统计学意义;两组T3时间点的体内纤维蛋白原水平均基本恢复至T1时间点水平。结论:在静脉通路建立有效性受阻或急救状态下,低温急性失血伤员骨内输注纤维蛋白原浓缩物是一种快速、有效的急救止血途径。Objective:To compare the difference of fibrinogen concentrate in different injection paths in acute hemorrhage model under cold conditions.Methods:Twelve bama pigs were selected to establish acute blood loss model and were randomly divided into intraosseous(IO)group and intravenous(IV)group,6 cases in each group.The blood loss was controlled at 35 ml/kg,and the same amount of sodium lactate ringer′s solution was supplemented and then the fibrinogen concentrate was injected at 80 mg/kg in the two groups.The hematocrit(Hct),platelet(PLT),haemoglobin(Hb),white blood cell count(WBC),prothrombin time index(PTI),activated partial thromboplastin time(APTT),plasma fibrinogen concentration and coagulation status were compared at three time points(T1:after anesthesia induction,T2:after acute blood loss and rehydration,T3:30 min after treatment with fibrinogen concentrate).Results:There were no statistically significant differences in Hct,Hb,PLT,WBC,PTI,APTT between the two groups at T1,T2 and T3.Fibrinogen levels in the two groups at T3 were returned to T1 level.Conclusion:When the establishment of venous access is blocked or in emergency,the intraosseous route of fibrinogen concentrate is a fast and effective way of emergency treatment in the patients with acute hypothermic hemorrhage.

关 键 词：骨内输注途径 纤维蛋白原浓缩物 急性失血 巴马猪 

分 类 号：R82[医药卫生—临床医学]