血液制品及其在伤病救治中的应用

Blood products and its applications for the treatment of military trauma and diseases

自第二次世界大战期间第一个血液制品,即人血白蛋白问世以来,血液制品在战创伤救治与急救医学中发挥了不可替代的作用。目前,血液和血液制品的保障体系日益完善,新型血液制品的研发也取得巨大进展。病毒灭活通用型冻干血浆已有军方采购;白蛋白作为战创伤急救用理想的抗休克血容量扩张剂,出现了不同浓度、高纯及软包装产品;特异性免疫球蛋白制品在救治战创伤感染、新发传染病防治、应对生物战剂与生物恐怖潜在威胁等方面,已成为某些发达国家的常规贮备;基于纤维蛋白原、凝血酶等制备的局部止血剂以及重组凝血因子Ⅶ的整体止血效果,使得这类产品在战创伤出血救治中的作用日益显现;作为战创伤脓毒血症救治的潜在药物,人蛋白C、抗凝血酶等抗凝蛋白的研究已经取得了明显进展;α2-巨球蛋白等蛋白酶抑制剂,有望成为特种医学救治的良药。可以认为,在未来战争和非战争军事行动中,血液制品将会发挥更大的作用。

The first blood product albumin was developed during World War Ⅱ. Since then, blood products began to play an irreplaceable role in military trauma and emergency cares. Currently, the supporting system of blood and blood products has become increasingly sophisticated. Development of novel blood products also improved dramatically. Universal virus inactivated freeze-dried plasma has also been purchased by the military. Albumin is used as antishoek blood volume expansion for emergency treatment of military trauma. Different kinds of albumin including albumin of various concentra- tions, high purity albumin and albumin in soft packages are available. Specific immunoglobulin has become the regular strategic storage of some developed countries, used for the prevention and treatment of infection in military trauma, emerging infectious diseases and against the potential threat of bioagents and bioterrorlsm. Local hemostatic produced upon fibrinogen and thrombin as well as coagulator Factor Ⅶ performing integral hemostasis effect have become increasingly significant for treating hemorrhage in military trauma. Development of anticoagulants including human protein C and antithrombin has got great improvement. These medicines have the potential for preventing and treating sepsis caused by military trauma. Prote- ase inhibitors including a2-macroglobulin are expected to work in the specific medicine. In conclusion, blood products will play a greater role in the future war and non war military operations.