云南白药保险子在重度创伤性失血急救中的应用  

Application of Yunnan Baiyao Baoxianzi in emergency treatment of severe traumatic hemorrhage

作　　者：李冉 付超 刘杨 刘明法[2] LI Ran;FU Chao;LIU Yang;LIU Mingfa(Cardiac Surgery Department of Hohhot First Hospital,Hohhot 010030,China;Emergency Medicine Department of Hohhot First Hospital,Hohhot 010030,China;UItrasonic Diagnosis Department of Hohhot First Hospital,Hohhot 010030,China)

机构地区：[1]呼和浩特市第一医院心脏血管外科,呼和浩特010030 [2]呼和浩特市第一医院急诊医学科,呼和浩特010030 [3]呼和浩特市第一医院超声医学科,呼和浩特010030

出　　处：《科技导报》2022年第23期78-84,共7页Science & Technology Review

基　　金：国家自然科学基金项目(82160130);内蒙古自治区自然科学基金项目(2020MS08135)。

摘　　要：创伤性失血是急救领域的重要挑战,可导致凝血-抗凝系统紊乱,云南白药保险子是中医经典急救药物,兼有止血和抗凝的功效。以2018年1月至2021年12月期间在呼和浩特市第一医院急诊中心收治的骨科创伤患者为研究对象,通过前瞻性平行对照临床研究,对保险子的止血疗效进行评价,指标包括术中出血量、术后引流量、血红蛋白下降值、凝血酶原时间(PT)、激活部分凝血酶原时间、纤维蛋白原(FBG)、输血率,预后出血/凝血不良反应等。结果显示,保险子组(n=27)的术中出血量、术后引流量、血红蛋白下降值、输血率、PT以及预后出血/凝血不良反应均显著小于对照组(n=24),保险子组FBG显著高于对照组;说明保险子能够维持机体凝血-抗凝系统的平衡,在显著降低出血量的同时,兼具抗凝的功效,可预防创伤性凝血病,减少预后不良反应。Traumatic hemorrhage is an important challenge in the field of first aid and may cause imbalance of the coagulationanticoagulation system. Yunnan Baiyao Baoxianzi is a classic first-aid medicine in the treatment of traumatic hemorrhage in traditional Chinese medicine. It has the effects of both hemostasis and anticoagulation. In this study, orthopaedic trauma patients at the emergency center of Hohhot First Hospital from Jan 2018 to Dec 2021 were taken as the research objects. Through a prospective parallel controlled clinical study, the hemostatic efficacy of baozi was systematically evaluated in terms of intraoperative blood loss, postoperative drainage, hemoglobin decline, prothrombin time(PT), activated partial prothrombin time,fibrinogen(FBG), blood transfusion rate, prognosis of bleeding/coagulation adverse reactions, etc. The results showed that the intraoperative bleeding volume, postoperative drainage volume, hemoglobin decline, blood transfusion rate, PT, and prognosis of bleeding/coagulation adverse reactions in the Baoxianzi group(n=27) were significantly lower than those in the control group(n=24) and the FBG in the Baoxianzi group was significantly higher than that in the control group. Thus, Baoxianzi can maintain the balance of coagulation-anticoagulation system, significantly reduce bleeding volume and benefit anticoagulation at the same time,preventing TIC and reducing adverse prognosis reactions.

关 键 词：云南白药保险子 创伤性失血 凝血-抗凝系统 创伤性凝血病 出血量 凝血功能 血栓 

分 类 号：R269[医药卫生—中西医结合]