参麦注射液联合血必净对创伤失血性休克早期患者凝血功能和炎症因子的影响

Shenmai injection combined with Xuebijing injection on blood coagulation function of early traumatic shock

目的探讨参麦注射液联合血必净对创伤失血性休克早期患者凝血功能和炎症因子的影响。方法选取2012年12月~2015年12月宁波医疗中心李惠利医院收治的86例创伤失血性休克患者,随机分成对照组（n=43）和实验组（n=43）。对照组采用液体复苏液和血必净注射液治疗,实验组在对照组基础上增加参麦注射液治疗。比较2组患者治疗前后凝血功能和炎性因子指标水平变化。结果治疗前2组患者各指标值无差异,治疗后2组患者凝血酶原时间（prothrombin time,PT）、凝血酶时间（thrombin time,TT）、活化部分凝血酶时间（activated partial thromboplastin time,APTT）和血小板计数（platelet count PLT,PLT）与治疗前比较均升高,纤维蛋白原（fibrinogen,FIB）降低,且2组间差异显著（P〈0.05或P〈0.01）,对照组治疗后0.5h各指标与治疗前比较无显著差异;2组患者治疗后各炎症指标明显上升（P〈0.01）,对照组明显高于实验组,且组间差异显著（P〈0.01）;与治疗第1 d相比,治疗第7 d 2组血流变学各项指标均明显降低,且实验组明显低于对照组（P〈0.01）。结论血必净联合参麦注射液能够有效改善创伤失血性休克患者的早期凝血功能,降低炎症因子水平,改善患者血液流变学各项指标,具有良好的临床效果。

Objective To explore the effects of Shenmai injection combined with Xuebijing injection on the coagulation function of the early and inflammatory factor traumatic hemorrhagic shock. Method 86 cases of traumatic hemorrhagic shock patients select from December 2012 to December2015 in our hospital were randomly divided into a control group（ n = 43） and experimental group（ n = 43）. The control group was fluid resuscitation and Xuebijing injection treatment,the experimental group was increased Shenmai injection treatment in the control group basis. Compared with coagulation function and inflammatory factor levels before and after treatment in two groups of patients. Results 2 groups of patients was no difference in the index values before treatment,compared with before treatment,after treatment,the two groups of patients prothrombin time（ PT）,thrombin time（ TT）,activated partial thromboplastin time（ APTT） and platelet count（ PLT） were elevated,fibrinogen（ FIB） was decreased,and the two groups were significantly different（ p〈0. 05 or p〈0. 01）,but in the control group was no difference in the index values after 0. 5 h treatment; The inflammatory factor in two groups were significantly increased after treatment（ p〈0. 01）,the control group was significantly higher than the experimental group,a significant difference between the groups（ p〈0. 01）; The hemorheology indexes after treatment 7 d of 2 groups were significantly decreased compared with after treatment 1 d,and the experimental group was significantly lower than the control group（ p〈0. 01）. Conclusion The combined therapy of Xuebijing injection combined with Shenmai injection can effectively improve trauma patients with hemorrhagic shock early coagulation function,reduce the levels of inflammatory factors,improve hemorheology indexes,there are good clinical results.