氨甲环酸在急性创伤失血患者中的应用效果  

Application of Tranexamic Acid in Patients with Acute Traumatic Blood Loss

作　　者：杨镇有 孙颖 王境乾 YANG Zhenyou;SUN Ying;WANG Jingqian(Department of Emergency Medicine,the Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian,361000,China)

机构地区：[1]厦门医学院附属第二医院急诊医学科,福建厦门361000

出　　处：《中外医疗》2025年第3期71-74,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨急性创伤失血患者采用氨甲环酸(tranexamic acid,TXA)的应用效果。方法 方便选取2022年7月—2024年7月厦门医学院附属第二医院收治的106例急性创伤失血患者为研究对象,根据不同治疗方案分成对照组(n=53)和研究组(n=53),对照组给予常规治疗,研究组在对照组基础上给予TXA治疗,对两组凝血功能、血栓弹力图指标变化、血清炎性因子水平、血制品用量、不良事件进行比较。结果 激活部分凝血酶原时间、凝血酶原时间两组治疗后均缩短,研究组更短;纤维蛋白原浓度提高,研究组更高,差异均有统计学意义(P均<0.05)。治疗后,两组最大振幅较治疗前升高,凝血形成时间与凝血反应时间均短于治疗前,且研究组最大振幅高于对照组,凝血形成时间、凝血反应时间均短于对照组;肿瘤坏死因子-α、白细胞介素-6水平均低于治疗前,且研究组更低;新鲜冰冻血浆、红细胞用量研究组均更少,差异均有统计学意义(P均<0.05)。不良事件总发生率研究组更低[1.89%(1/53)比15.09%(8/53)],差异有统计学意义(χ^(2)=4.371,P<0.05)。结论 急性创伤失血患者采用TXA治疗,能够改善凝血功能,减少血制品用量,降低炎症因子水平,减少不良事件发生。Objective To explore the application effect of tranexamic acid(TXA)in patients with acute traumatic blood loss.Methods A total of 106 patients with acute traumatic blood loss admitted to the Second Affiliated Hospital of Xiamen Medical College from July 2022 to July 2024 were convenient to select as the research objects.According to different treatment regimens,they were divided into a control group(n=53)and a study group(n=53).The control group was given conventional treatment,while the study group was given TXA treatment on the basis of the control group.The changes in coagulation function,thromboelastogram index,the level of serum inflammatory factors,the amount of blood products used,and adverse events were compared between the two groups.Results Activated partial thromboplastin time and prothrombin time were shorter in both groups after treatment,and shorter in the study group;fibrinogen concentration was increased,and higher in the study group,and the differences were statistically significant(all P<0.05).After treatment,the maximum amplitude of both groups was higher than that before treatment,and the co-agulation formation time and coagulation reaction time were shorter than that before treatment,and the maximum am-plitude of the research group was higher than that of the control group,and the coagulation formation time and coagula-tion reaction time were shorter than that of the control group;the levels of tumour necrosis factor-αand interleukin-6 were lower than that before treatment,and the levels of these two factors were lower in the research group,and the dos-age of fresh frozen plasma and erythrocytes was lower in the research group,with statistically significant differences(all P<0.05).The total incidence of adverse events was lower in the study group[1.89%(1/53)vs 15.09%(8/53)],and the difference was statistically significant(χ^(2)=4.371,P<0.05).Conclusion The application of TXA in patients with acute traumatic blood loss can improve coagulation function,reduce the amount of blood products used

关 键 词：氨甲环酸 急性创伤失血 凝血功能 

分 类 号：R605[医药卫生—外科学]