CAJ | 학술논문

目的评价重组活化Ⅶ因子(recombinant activated factorⅦ,rⅦa)治疗严重多发伤失血性休克伴凝血功能障碍的效果. 方法回顾性分析2011年7月-2012年6月收治的16例严重多发伤凝血功能障碍并使用rⅦa治疗的患者,比较使用rⅦa前后血制品使用量和凝血象变化情况. 结果用药后9例24 h内出血停止,7例出血减少并在72 h内停止.生存13例,死亡3例.生存患者未见心肌梗死、脑血管意外、深静脉血栓发生.末次给药后48 h较首次给药前48 h输注红细胞、新鲜冰冻血浆、冷沉淀、血小板用量均减少,其中新鲜冰冻血浆及冷沉淀减少差异有统计学意义(P＜0.05)；在首次给药前及末次给药后4h内,凝血象指标凝血酶原时间、活化部分凝血活酶时间比较差异有统计学意义(P＜0.05). 结论 rⅦa是严重多发伤凝血功能障碍时作为外科手术止血后的重要补充手段,效果明显、安全性高.
목적 평개중조활화Ⅶ인자(recombinant activated factorⅦ,rⅦa)치료엄중다발상실혈성휴극반응혈공능장애적효과. 방법 회고성분석2011년7월-2012년6월수치적16례엄중다발상응혈공능장애병사용rⅦa치료적환자,비교사용rⅦa전후혈제품사용량화응혈상변화정황. 결과 용약후9례24 h내출혈정지,7례출혈감소병재72 h내정지.생존13례,사망3례.생존환자미견심기경사、뇌혈관의외、심정맥혈전발생.말차급약후48 h교수차급약전48 h수주홍세포、신선빙동혈장、랭침정、혈소판용량균감소,기중신선빙동혈장급랭침정감소차이유통계학의의(P＜0.05)；재수차급약전급말차급약후4h내,응혈상지표응혈매원시간、활화부분응혈활매시간비교차이유통계학의의(P＜0.05). 결론 rⅦa시엄중다발상응혈공능장애시작위외과수술지혈후적중요보충수단,효과명현、안전성고.
Objective To evaluate the effect of recombinant activated factor Ⅶ (rⅦa) in treatment of hemorrhagic shock after severe multiple injuries with coagulopathy.Methods Sixteen cases of coagulopathy after severe multiple injuries administered with rⅦa between July 2011 and June 2012 were reviewed.The requirements of blood product and coagulogram variation were comparatively studied before and after rⅦa therapy.Results After rⅦa therapy,bleeding was brought to a halt in 24 hours for nine cases and in 72 hours for seven cases.In the end,13 out of the 16 cases survived in the absence of myocardial infarct,cerebrovascular accident or deep vein thrombosis.Requirements of red blood cells,fresh frozen plasma,cryoprecipitate and platelet (PLT) were decreased at 48 hours after the final therapy as compared with those at 48 hours prior to the primary therapy,but statistical significance only existed in the reduction of fresh frozen plasma and cryoprecipitate (P ＜ 0.05).The coagulogram indices including prothrombin time (PT) and activated partial thromboplastin time (APTT) at 4 hours after the final therapy presented statistical differences from those prior to the primary therapy (P ＜ 0.05).Conclusion rⅦa is an important,effective and safe auxiliary means for surgical hemostasis of coagulopathy after severe multiple injuries.