重组活化凝血因子Ⅶa在腹部手术后难治性大出血的疗效研究

Therapeutic Effect of Recombinant Activated Coagulation Factor Ⅶ on Intractable Massive Hemorrhage after Abdominalsurgery

目的探讨重组活化凝血因子Ⅶa(recombinant activated factor Ⅶ,rFⅦa)治疗腹部手术后难治性大出血的临床疗效。方法回顾性分析我院外科ICU 2009年6月至2017年4月应用rFⅦa治疗普通外科腹部手术后难治性大出血患者44例,与同期的38例腹部手术后大出血患者进行对比,记录两组患者的基本资料、成分输血量以及28d死亡率和血栓相关性并发症,并做统计分析。结果试验组患者使用rFⅦa治疗难治性大出血后其成分输血减少。和对照组患者比较,28d死亡率降低(42.1%vs 65.9%,P=0.031),两组患者的血栓相关性并发症差异无统计学意义(9%vs 8%,p=0.703)。结论对于腹部手术后难治性大出血,应用rFⅦa可取得较好的治疗效果。

Objective To investigate the clinical efficacy of recombinant activated factor VII（rFVIIa） in the treatment of intractable massive hemorrhage after abdominal surgery. Methods 44 patients with refractory massive hemorrhage after general abdominal surgery treated by rFVIIa in department of surgical ICU in our hospital from June 2009 to April 2017 were retrospective- ly analyzed and compared with 38 eases of massive hemorrhage after abdominal operation in the same period. The basic data, com- ponent transfusion volume, and 28 day mortality and thrombosis related complications were recorded and analyzed statistically in the two groups. Results After the treatment of refractory massive hemorrhage with rFVIIa, the blood transfusion of patients in the ex- perimental group decreased. Compared with the control group, the 28 day mortality rate decreased （42. 1% vs 65.9 % , P = 0. 031 ）, and there was no significant difference in thrombosis related complications between the two groups（9% vs 8% , P = O. 703 ）. Con- chlsion For patients with intractable massive bleeding after abdominal surgery, the use of rFVIIa can achieve better therapeutic effect.