早期应用人纤维蛋白原对创伤患者凝血功能及预后的影响

Effect of early application of human fibrinogen on coagulation function and prognosis of trauma patients

目的探讨早期应用人纤维蛋白原对创伤患者凝血功能及预后的影响。方法选择50例创伤患者,随机分为实验组(n=17)和对照组(n=33),实验组予以术前使用人纤维蛋白原,对照组予以术后使用人纤维蛋白原。观察两组患者在14 d内凝血功能变化、血栓发生率、死亡率等指标。结果使用14 d后,实验组患者的纤维蛋白原(FIB)明显高于对照组(t=2.78,P<0.05),两组的凝血酶原时间(PT)、凝血酶原时间国际标准化比值(PT-INR)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及D-二聚体比较,差异均无统计学意义(t分别=-0.94、-0.82、-0.38、-1.46、0.37,P均>0.05)。实验组患者的血栓发生率和死亡率与对照组比较,差异均无统计学意义(χ2分别=0.11、0.08,P均>0.05)。结论相比术后应用人纤维蛋白原,术前使用人纤维蛋白原更能有效维持创伤患者的FIB水平。

Objective To investigate the effect of early application of human fibrinogen on coagulation function and prognosis of trauma patients.Methods Totally 50 cases with trauma were randomly divided into experimental group(n=17)and control group(n=33).The experimental group was given human fibrinogen before surgery,and the control group was given human fibrinogen after surgery.The changes of coagulation function,incidence of thrombosis,and mortality in 14 days were observed.Results After 14 days,the fibrinogen of experimental group patients was significantly higher than control group(t=2.78,P<0.05).The differences in prothrombin time(PT),international standardization ratio of prothrombin time(PT-INR),activated partial clotting enzyme live time(APTT),thrombin time(TT)and D-dimer between two groups were not statistically significant(t=-0.94,-0.82,-0.38,-1.46,0.37,P>0.05).There was no significant difference in thrombus incidence and mortality between two groups(χ2=0.11,0.08,P>0.05).Conclusion Compared with the postoperative application of human fibrinogen,preoperative application of human fibrinogen can effectively maintain the level of fibrin of trauma patients.