氨甲环酸对创伤性凝血病患者的疗效及作用机制

Effect and mechanism of Tranexamic Acid on traumatic coagulopathy

目的探讨氨甲环酸对创伤性凝血病患者的临床疗效及作用机制。方法选取2015年4月-2016年6月就诊于该院的创伤性凝血病患者106例,根据随机数表法原则将所有患者分为两组,各53例。对照组采用常规疗法,如手术止血、输注血制品及补充钙质。观察组在此基础上加用氨甲环酸治疗。比较两组治疗指标、炎症因子水平、血制品输注量及预后。结果观察组凝血酶原时间(PT)、活化部分凝血或酶时间(APTT)及纤维蛋白原(Fbg)等指标改善情况优于对照组,差异有统计学意义(P<0.05);观察组肿瘤坏死因子α(TNF-α)等炎症因子水平低于对照组,差异有统计学意义(P<0.05);观察组血制品输用量少于对照组,差异有统计学意义(P<0.05);观察组预后情况优于对照组,差异有统计学意义(P<0.05)。结论氨甲环酸治疗创伤性凝血病效果显著,能够减少出血量,改善患者凝血功能,降低炎症反应,有助于改善预后。

Objective To explore the clinical effect and mechanism of Tranexamic Acid on the treatmentof traumatic coagulopathy. Methods A total of 106 patients with traumatic coagulopathy from April 2015 toJune 2016 were selected and randomly divided into two groups according to the random number table, with53 cases in each group. The control group was treated with conventional therapies including surgicalhemostasis, transfusion of blood products and calcium supplement, while the observation group was treatedwith Tranexamic Acid and the conventional theropies. The treatment index, level of inflammatory factors, bloodtransfusion and prognosis in the two groups were compared. Results Prothrombin time （PT）, activated partialthromboplastin time （APTT）, fibrinogen （Fbg） and other indicators in the observation group were significantlyimproved compared with the control group（ 〈 0.05）; the levels of tumor necrosis factor-琢 （TNF-琢） and otherinflammatory factors in the observation group were significantly lower than those in the control group （ 〈0.05）; the transfusion of blood products in the observation group was significantly less than that in the controlgroup（ 〈 0.05）; the prognosis of the observation group was significantly better than that of the control group（ 〈 0.05）. Conclusions Tranexamic Acid hasa pronounced effect on traumatic coagulopathy, which cansignificantly reduce the amount of bleeding, improve the coagulation function and reduce inflammation, thushelp to improve the prognosis.