摘要
目的探讨血必净（xBJ）、喜炎平、钠络酮（Nx）联合应用对重症胸腹损伤急性凝血功能障碍的疗效。方法将2009年1月至2012年6月在呼和浩特第二五三医院急诊科就诊，创伤指数（ffaumaindex，TI）≥17分者纳入，合并颅脑损伤及在急诊死亡的胸腹损伤患者排除。按患者要求及经济承受能力分为两组，治疗组82例、对照组47例；治疗组用药前及用药后分别检查血小板计数（PLT）、血浆D-二聚体（D-D）、部分活化凝血酶原时间（APPT）、凝血酶原时间（PT）、凝血酶时间（TT）；肿瘤坏死因子-α（TNF-Ⅱ）、内毒素（LPS）、白细胞介素．6（IL-6）、磷脂酶A2（PLA2）和血小板活化因子（PAF），对照组仅于用药后进行同项目检查。结果治疗组用药前PLT（83．44±38．52）10^9/L、D．D（1823．89±608．02）U／L、APTT为（68．24±24．12）S、PT为（28．42±10．83）S、TT为（58．27±12．44）S、PLA2（41．35±14．26）nedroa、PAJF（15765．31±4431．65）ng／L：用药后PLT为（127．59±27．18）109／L、D-D为（769．42±106．34）U／L、APTT为（49．11±12．76）S、PT为（19．51±8．23）S、Tr为（31．44±9．17）S、PLA2（19．16±7．11）ng／ml、PAF（6722．56±1049．34）ng／L；对照组用药后PLT为（89．22±31．27）109／L、D。D为（1814．45±643．18）U／L、APTT为（63．48±28．27）S、PT为（27．79±11．94）S、TT为（60．51±14．23）s、PLA2（44．71±16．52）n∥ml、PAF（15933．07±4573．19）ng／L。治疗组用药后PLT升高、D-D、APTT、PT、TT降低；TMF-α、LPS、IL-6、PLA2、PAF表达下降，与同组用药前及对照组比较，差异有统计学意义（P〈0．01）。结论XBJ、喜炎平、NX联合治疗可改善重症胸腹损伤患者的凝血功能障碍，减少并发症，提高生存率。
Objective To observe the therapeutic effectiveness of the early intervention of Xuebijing （XBJ） Xiyanping and Naloxone （NX） in acute coagulation disorders during severe thoracoabdominal injuries. Methods Severe thoracoabdominal injury patients with trauma index （TI） ≥17 points except the ones associated craniocerebral injuries and died in emergency department were randomly divided into two groups： a intervention group （n=82） and a control group （n=47） ; The patients were all collected at 253th Hosptital of PLA between January 2009 and June 2012. The intervention group was tested at the time of arriving at the emergency department and the time of leaving the emergency department to the inpatient department for platelet count （PLT）, D-dimer （D-D）, activated partial thromboplastin （APPT）, prothrombin time （PT）, thromboplastin time （TT）, tumor necrosis factor-or （TNF〈t）, lipopolysaccharide （LPS）, interleukin-6 （IL-6）, phospholipase A2 （PLA2） and platelet-activating factor（PAF）. The control group was just tested at the time of leaving the emergency department for the same items. Results At the time of arriving at the emergency department, PLT was （83.44±38.52） 109/L, D-D was （1 823.89±608.02） U/L, APTT was （68.24±24.12） s, PT was （28.42± 10.83） s, TT was （58.27± 12.44） s, PLA2 （41.35 ± 14.26） ng/ml, PAF （ 15 765.31± 4431.65 ） ng/L; At the time of leaving the emergency department, PLT was （127.59 ± 27.18） 109/L, D-D was （769.42 ± 106.34） U/L, APTT was （49.11± 12.76） s, PT was （19.51 ± 8.23） s, TT was （31.44± 9.17） s, PLA2 （ 19.16± 7.11 ） ng/ml, PAF （ 6 722.56 ± 1 049.34） ng/L; At the time of leaving the emergency department the records of the control group of severe thoracoabdominal injury patients, PLT was （89.22 ± 31.27） 109/L, D-D was （1 814.45 ± 643.18） U/L, APTT was （63.48 ± 28.27） s, PT was （27.79± 11.94） s, TT was （60.51 ± 14.23） s, PLA2 （44.71 ± 16.52） ng/ml, PAF （ 15 933.07 ± 4 573.19） ng/L. After the intervention the records of PLT were higher, the ones of D-D, APTT, PT, TT were lower; the records of TNF-ct, LPS, IL-6, PLA2 and PAF were significantly lower than the time before intervention and the control group （all P〈0.01）. Conclusion XBJ, Xiyanping and NX can significantly improve the acute coagulation disorders during severe thoracoabdominal injuries which have important significance in reducing incidence rate of complication, preventing multiple organ dysfunction score （MODS）, improving prognosis and increasomg survival rate.
出处
《国际中医中药杂志》
2014年第3期209-212,共4页
International Journal of Traditional Chinese Medicine
关键词
重症胸腹损伤
急性凝血功能障碍
血必净
喜炎平
钠络酮
救治效果分析
Severe thoraco-abdominal injuries
Acute coagulation disorders
Xuebijing
Xiyanping
Naloxone
Treatment effectiveness analysis
