不同方式输注rFVII治疗创伤性凝血病临床观察.docVIP

不同方式输注rFVII治疗创伤性凝血病的临床观察 　　【摘要】 目的：比较不同方式输注重组人凝血因子rFVII治疗创伤性凝血病的治疗效果。方法：将90 例创伤性凝血病患者随机分为持续输注组（C组，30例）、单次给药组（S组，30例）和对照组（N组，30 例）。三组在综合治疗的基础上均按 1∶1∶1输注浓缩红细胞、冰冻血浆、血小板。C组输注rFVII，首次剂量90 μg/kg，随后按30 μg/（kg?h）持续静脉输注，S组输注rFVII 90 μg/kg，2 h再按同剂量给予 1 次。分别观察三组治疗后 24、48 h 快速血栓弹力图指标变化和输血量的变化。结果：治疗后 24、48 h快速血栓弹力图指标变化，C组、S组ACT值、K值均低于N组；C、S组α值、MA值高于N组；C组、S组输注的红细胞悬液、冰冻血浆、冷沉淀和血小板的量均少于N组（ P0.05） ，C组与S组各指标比较差异无统计学意义，但C组改善情况好于S组。结论：持续输注 rFⅦa 在控制创伤性凝血病方面具有更好的效果，优于单次输注。 　　【关键词】 创伤性凝血病； 重组人凝血因子rFVII； 快速血栓弹力图； 输血量 　　The Investigation of Different Administrations of rFVII for Trauma-induced Coagulopathy/GE Bo-yong，WANG Yu-bo，WANG Ming-tai.//Medical Innovation of China，2015，12（30）：020-022 　　【Abstract】 Objective：To compare different administrations of rFVII for trauma-induced coagulopathy （TIC）.Method：All of 90 patients with TIC were randomly divided into continue-infusion group（Group C，30 cases），single-dose group（Group S，30 cases）and normal group（Group N，30 cases）.Each of which received blood coagulation substrates including RBC，blood plasma and platelets（1∶1∶1）as resuscitation. Patients in group C received the first dose of transfusion of rFVII 90 μg/kg，followed by a continuous infusion of 30 μg /（kg?h） at 48 h therapy. Patients in Group S received the first dose of transfusion of rFVII 90 μg/kg，followed with another same dose 2 h later.The venous blood were collected for r-TEG test after 24 h and 48 h.The transfusion volume of blood coagulation substrates during the following 48 h were analyzed.Result：The parameter of r-TEG test and the transfusion volume of blood coagulation substrates after 24 h and 48 h in Group C were significantly different than those in the other two groups（P 0.05）. Conclusion：Compared with single-dose group，continue-infusion of rFVII is effective in the treatment for the patients with TIC. 　　【Key words】 Trauma-induced coagulopathy； rFVII； r-TEG； Transfusion volumes 　　First-author’s address：The Second Affiliated Hospital of Zhengzhou University，Zhengzhou 450