血必净、钠络酮、磷酸肌酸钠对重症胸腹损伤患者急性凝血功能障碍的早期干预效果分析

Early Intervention Effect of Xuebijing,Naloxone and Creatine Phosphate Sodium in Acute Coagulation Disorders during Severe Thoraco- Abdominal Injuries.

目的:探讨血必净(XBJ)、钠络酮(NX)、磷酸肌酸钠(PCr)对重症胸腹损伤患者急性凝血功能障碍的早期干预效果。方法:创伤指数(TI)≥17分,除外合并颅脑损伤及急诊死亡的重症胸腹损伤患者,干预组82例,对照组47例;患者分别干预前后检测血小板计数(PLT)、血浆D-二聚体(D-D)、部分活化凝血酶原时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT);肿瘤坏死因子-α(TNF-α)、内毒素(LPS)、白细胞介素-6(IL-6)、磷脂酶A2(PLA2)和血小板活化因子(PAF)。结果:干预组治疗后PLT升高、D-D、APTT、PT、TT降低;TNF-α、LPS、IL-6、PLA2、PAF表达下降,与干预前及对照组相比差异显著(P<0.01)。结论:XBJ、NX、PCr治疗可显著改善胸腹损伤患者的凝血功能,对减少并发症、预防多器官功能障碍综合征(MODS)、改善伤者预后具有重要作用。

Objective：To observe the early intervention effect of Xuebijing,naloxone and creatine phosphate sodium on acute coagulation disorders during severe thoraco abdominal injuries.Methods：Severe thoraco abdominal injury patients with trauma index （TI） ≥17 points except the ones associated craniocerebral injuries and died in emergency department were randomly divided into two groups：intervention group （n =82） and control group （n =47） ; platelet count （PLT）,D-dimer （D-D）,activated partial thromboplastin time （APTT）,prothrombin time （PT）,thromboplastin time （TT）,tumor necrosis factor-α（TNF-α）,lipopolysaccharide （LPS）,interleukin-6 （IL-6）,phospholipase A2 （PLA2） and platelet-activating factor （PAF） in patients were determined before and after interred.Results：The PLT increased after treated,D-D,APT,PT and TT were reduced significantly,TNF-α,LPS,PLA2 and P AF levels were decreased obviously,the effects of intervention group were better than those in control group.Conclusions：Xuebijing,naloxone and creatine phosphate sodium can significantly improve the acute coagulation disorders during severe thoraco abdominal injuries which have important significance in reducing incidence rate of complication,preventing multiple organ dysfunction syndrome （MODS） and improving prognosis and increase survival rate.