摘要
目的:探讨重型颅脑创伤患者早期运用重组活化凝血因子Ⅶa(recombinant activated factorⅦa,rFⅦa)的临床疗效。方法:选取重型颅脑创伤患者50例,随机分为治疗组及对照组,每组25例。治疗组受伤3 h内给予静脉注射rFⅦa,剂量40μg/kg;对照组受伤3 h内给予静脉注射止血敏1.0 g。比较两组入院时(0 h),伤后24 h、72 h及7 d的凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白(原)降解产物[fibrin(-ogen)degradation products,FDP]、D-二聚体凝血值及术中出血量、迟发性颅内出血再次手术率、病死率及术后3个月格拉斯哥预后(Glasgow outcome scale,GOS)评分。结果:与对照组相比,治疗组PT、APTT、FDP、D-二聚体的异常振幅降低;治疗组术中出血量、术后1周内红细胞悬液用量、迟发性颅内出血再次手术率及病死率均明显低于对照组,且术后3个月GOS评分明显高于对照组,差异均有统计学意义(P<0.05)。结论:重型颅脑创伤患者早期使用rFⅦa可改善患者凝血功能,减少并发症,降低病死率,改善患者预后。
Objective:To investigate the clinical efficacy of the early use of recombinant activated factorⅦa(rFⅦa)in patients with severe traumatic brain injury.Methods:Fifty cases of severe traumatic brain injury were randomly divided into the treatment group(n=25)and the control group(n=25).The treatment group were given intravenous injection rFⅦa(40μg/kg),and the control group were given intravenous hemostatic(1.0 g)within 3 h of the injury.Prothrombin time(PT),activated partial thromboplastin time(APTT),fibrin(-ogen)degradation products(FDP),D-dimer value of 0 h,24 h,72 h and 7 d,and intraoperative hemorrhage,late intracranial hemorrhage reoperation rate,mortality rate,Glasgow outcome scale(GOS)score for 3 months after surgery were compared.Results:Compared with the control group,the value of PT,APTT,FDP and the abnormal amplitude of D-dimer of the treatment group were reduced,and intraoperative blood loss,the amount of suspended red blood cells in 1 week after surgery,late intracranial hemorrhage reoperation rate and the mortality rate of the treatment group were significantly lower than those of the control group,and the GOS score of the treatment group was significantly higher than that of the control group.These differences were statistically significant(P<0.05).Conclusion:The early use of rFⅦa in patients with severe traumatic brain injury can improve the patients′coagulation function,and reduce complications and mortality,so it can improve clinical efficacy and the prognosis of patients.
作者
赵军
宋大勇
程远弛
李志强
涂悦
张赛
ZHAO Jun;SONG Dayong;CHENG Yuanchi;LI Zhiqiang;TU Yue;ZHANG Sai(Department of Neurosurgery,Central Hospital of Fengxian District,Shanghai 201499,China;Brain Center Hospital Affiliated to Armed Police Logistics College)
出处
《西北国防医学杂志》
CAS
2020年第6期352-355,共4页
Medical Journal of National Defending Forces in Northwest China
基金
国家自然科学基金资助项目(31200809)
天津市科技计划项目(15ZXLCSY00040)
上海奉贤区科委资助项目(20161112)。
关键词
重型颅脑创伤
重组活化凝血因子Ⅶa
凝血功能
severe traumatic brain injury
recombinant activated factorⅦa
coagulation function
