国际中医中药杂志
國際中醫中藥雜誌
국제중의중약잡지
INTERNATIONAL JOURNAL OF TRIDITIONAL CHINESE MEDICINE
2014年
3期
209-212
,共4页
李志伟%王著军%徐旭%郭雅琼%乔帅%梁永刚%马之嘉%冀蒙%郝莉
李誌偉%王著軍%徐旭%郭雅瓊%喬帥%樑永剛%馬之嘉%冀矇%郝莉
리지위%왕저군%서욱%곽아경%교수%량영강%마지가%기몽%학리
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
重癥胸腹損傷%急性凝血功能障礙%血必淨%喜炎平%鈉絡酮%救治效果分析
중증흉복손상%급성응혈공능장애%혈필정%희염평%납락동%구치효과분석
Severe thoraco-abdominal injuries%Acute coagulation disorders%Xuebijing%Xiyanping%Naloxone%Treatment effectiveness analysis
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(trauma index,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-α)、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) 109/L、D-D(1 823.89±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) ng/ml、PAF (15 765.31±4 431.65) 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、TT为(31.44±9.17)s、PLA2 (19.16±7.11) ng/ml、PAF (6 722.56±1 049.34) ng/L;对照组用药后PLT为(89.22±31.27) 109/L、D-D为(1 814.45±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) ng/ml、PAF (15 933.07±4 573.19) 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.
目的 探討血必淨(XBJ)、喜炎平、鈉絡酮(NX)聯閤應用對重癥胸腹損傷急性凝血功能障礙的療效.方法 將2009年1月至2012年6月在呼和浩特第二五三醫院急診科就診,創傷指數(trauma index,TI)≥17分者納入,閤併顱腦損傷及在急診死亡的胸腹損傷患者排除.按患者要求及經濟承受能力分為兩組,治療組82例、對照組47例;治療組用藥前及用藥後分彆檢查血小闆計數(PLT)、血漿D-二聚體(D-D)、部分活化凝血酶原時間(APPT)、凝血酶原時間(PT)、凝血酶時間(TT);腫瘤壞死因子-α(TNF-α)、內毒素(LPS)、白細胞介素-6(IL-6)、燐脂酶A2 (PLA2)和血小闆活化因子(PAF),對照組僅于用藥後進行同項目檢查.結果 治療組用藥前PLT (83.44±38.52) 109/L、D-D(1 823.89±608.02) U/L、APTT為(68.24±24.12)s、PT為(28.42±10.83)s、TT為(58.27±12.44)s、PLA2 (41.35±14.26) ng/ml、PAF (15 765.31±4 431.65) ng/L;用藥後PLT為(127.59±27.18) 109/L、D-D為(769.42±106.34) U/L、APTT為(49.11±12.76)s、PT為(19.51±8.23)s、TT為(31.44±9.17)s、PLA2 (19.16±7.11) ng/ml、PAF (6 722.56±1 049.34) ng/L;對照組用藥後PLT為(89.22±31.27) 109/L、D-D為(1 814.45±643.18) U/L、APTT為(63.48±28.27)s、PT為(27.79±11.94)s、TT為(60.51±14.23)s、PLA2 (44.71±16.52) ng/ml、PAF (15 933.07±4 573.19) ng/L.治療組用藥後PLT升高、D-D、APTT、PT、TT降低;TMF-α、LPS、IL-6、PLA2、PAF錶達下降,與同組用藥前及對照組比較,差異有統計學意義(P＜0.01).結論 XBJ、喜炎平、NX聯閤治療可改善重癥胸腹損傷患者的凝血功能障礙,減少併髮癥,提高生存率.
목적 탐토혈필정(XBJ)、희염평、납락동(NX)연합응용대중증흉복손상급성응혈공능장애적료효.방법 장2009년1월지2012년6월재호화호특제이오삼의원급진과취진,창상지수(trauma index,TI)≥17분자납입,합병로뇌손상급재급진사망적흉복손상환자배제.안환자요구급경제승수능력분위량조,치료조82례、대조조47례;치료조용약전급용약후분별검사혈소판계수(PLT)、혈장D-이취체(D-D)、부분활화응혈매원시간(APPT)、응혈매원시간(PT)、응혈매시간(TT);종류배사인자-α(TNF-α)、내독소(LPS)、백세포개소-6(IL-6)、린지매A2 (PLA2)화혈소판활화인자(PAF),대조조부우용약후진행동항목검사.결과 치료조용약전PLT (83.44±38.52) 109/L、D-D(1 823.89±608.02) U/L、APTT위(68.24±24.12)s、PT위(28.42±10.83)s、TT위(58.27±12.44)s、PLA2 (41.35±14.26) ng/ml、PAF (15 765.31±4 431.65) ng/L;용약후PLT위(127.59±27.18) 109/L、D-D위(769.42±106.34) U/L、APTT위(49.11±12.76)s、PT위(19.51±8.23)s、TT위(31.44±9.17)s、PLA2 (19.16±7.11) ng/ml、PAF (6 722.56±1 049.34) ng/L;대조조용약후PLT위(89.22±31.27) 109/L、D-D위(1 814.45±643.18) U/L、APTT위(63.48±28.27)s、PT위(27.79±11.94)s、TT위(60.51±14.23)s、PLA2 (44.71±16.52) ng/ml、PAF (15 933.07±4 573.19) ng/L.치료조용약후PLT승고、D-D、APTT、PT、TT강저;TMF-α、LPS、IL-6、PLA2、PAF표체하강,여동조용약전급대조조비교,차이유통계학의의(P＜0.01).결론 XBJ、희염평、NX연합치료가개선중증흉복손상환자적응혈공능장애,감소병발증,제고생존솔.
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-α (TNF-α),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 ± 4573.19) 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-α、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.
