在严重创伤患者院前急救中使用血凝酶对患者预后的影响

Effect of Using Hemocoagulase on Prognosis of Patients With Severe Trauma in Pre-Hospital Emergency Treatment

目的 探讨血凝酶在严重创伤患者院前急救中的应用效果。方法 回顾性分析徐州矿务集团总医院2020年5月—2023年5月收治的86例严重创伤患者临床资料。按治疗方法不同分为2组,将院前急救使用氨甲环酸的42例设为对照组,院前急救使用血凝酶的44例设为观察组。比较2组止血效果、凝血功能指标、血栓弹力图参数、格拉斯哥预后评分(Glasgow outcome scale,GOS)、ICU住院时间、炎症水平。结果 观察组平均出血量、红细胞输入量少于对照组,治疗后血红蛋白水平高于对照组,治疗后凝血酶原时间(prothrombin time,PT)、活化部位凝血活酶时间(activated partial thromboplastin time,APTT)短于对照组,纤维蛋白原(fibrinogen,FIB)、血小板计数(platelet count,PLT)高于对照组(P <0.05);观察组治疗后反应时间(reaction time,R)及血凝块形成时间(kinetics,K)短于对照组短(P <0.05);观察组GOS评分为(3.78±0.43)分,高于对照组的(3.15±0.41)分,观察组ICU住院时间为(3.42±0.38)d,短于对照组的(5.14±1.02)d(P <0.05);观察组治疗后白介素-6(interleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)及肿瘤坏死因子-α(tumor necrosis factor,TNF-α)水平低于对照组(P <0.05)。结论 血凝酶在严重创伤患者院前急救中应用效果更佳,可改善患者凝血功能,减少出血量,缩短ICU住院时间,提高GOS评分。

Objective To investigate the application effect of hemagglutinin in pre-hospital emergency treatment of severe trauma patients.Methods The clinical data of 86 patients with severe trauma admitted to Xuzhou Mining Group General Hospital from May 2020 to May 2023 were retrospectively analyzed.They were divided into two groups according to different treatment methods.42 patients who used tranexamic acid in pre-hospital emergency treatment were set as the control group,and 44 patients who used hemagglutinin in pre-hospital emergency treatment were set as the observation group.The hemostatic effects,coagulation function indicators,thromboelastogram parameters,Glasgow outcome scale(GOS),ICU hospitalization time,and inflammation levels were compared between the two groups.Results The average blood loss and red blood cell input in the observation group were lower than those in the control group.After treatment,the hemoglobin level was higher than that in the control group,and prothrombin time(PT)and activated partial thromboplastin time(APTT)were shorter than those in the control group.Fibrinogen(FIB)and platelet count(PLT)were higher than those in the control group(P<0.05).After treatment,the reaction time(R)and kinetics(K)in the observation group were shorter than those in the control group(P<0.05).The GOS score of the observation group was(3.78±0.43)points,higher than that of the control group(3.15±0.41)points,ICU hospitalization time of the observation group was(3.42±0.38)d,shorter than that of the control group(5.14±1.02)d(P<0.05).The levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in the observation group after treatment were lower than those in the control group(P<0.05).Conclusion The application of hemagglutinin in pre-hospital emergency treatment for severe trauma patients is more effective,which can improve coagulation function,reduce bleeding volume,shorten ICU hospitalization time,and improve GOS score.