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目的:探讨损伤控制性复苏(DCR)方案配合等比例成分输血治疗多发伤并发创伤性凝血病(ATC)疗效。方法:选取2014-03-2015-03我院急诊创伤抢救室收治的ATC患者48例,治疗均采用DCR方案,治疗过程中患者输注浓缩红细胞(CRBC)和新鲜冰冻血浆(FFP)剂量不同,把其中CRBC和FFP按照1∶1及2∶1输注的患者进行研究分析。将患者分为2组,A组按照1∶1比例输注,B组按照2∶1输注。回顾分析患者入院后第1、2、3天血红蛋白(Hb)、凝血酶原时间(PT)、国际化标准比率(INR)、纤维蛋白原(FIB)水平、血压、中心静脉压(CVP)水平。结果:2组患者在入院后的第1天的Hb组间比较,差异无统计学意义(P>0.05),第1天与第2、3天Hb之间差异有统计学意义(P<0.05),入院第1天,2组患者的PT、INR、FIB比较,差异无统计学意义(P>0.05),各指标之间在第1天与第2、3天之间的比较差异有统计学意义(P<0.05)。入院后第2、3天A组PT、INR、FIB、血压、CVP优于对照组(P<0.05)。在救治多发伤并发ATC患者时,等比例成分输血可维持相同Hb及血凝目标值而节约红细胞(RBC)的输注,从经济学角度A组较B组人均治疗费少。结论:DCR方案配合等比例成分输血对多发伤并发ATC具有较好疗效。
Objective: To investigate the curative effect of trauma controlled resuscitation (DCR) combined with equal proportion blood transfusions on traumatic coagulopathy (ATC). Methods: Forty-eight patients with ATC were enrolled in emergency room of emergency room from March 2014 to May 2015 in our hospital. All patients underwent DCR. The doses of CRBC and FFP were different during treatment, In which CRBC and FFP 1: 1 and 2: 1 infusion of patients were analyzed. The patients were divided into two groups: group A received 1: 1 infusion and group B received 2: 1 infusion. The levels of hemoglobin (Hb), prothrombin time (PT), international standard ratio (INR), fibrinogen (FIB), blood pressure and central venous pressure (CVP) . Results: There was no significant difference in Hb between the two groups on the first day after admission (P> 0.05), but there was a significant difference between the first day and the second and third days (P <0.05) ). There was no significant difference in PT, INR, FIB between the two groups on the first day of admission (P> 0.05). There was statistical difference between the first day and the second and third day Significance (P <0.05). PT, INR, FIB, blood pressure and CVP in group A on the 2nd and 3rd day after admission were better than those of the control group (P <0.05). In the treatment of multiple trauma complicated with ATC patients, the same proportion of blood transfusion can maintain the same target value of Hb and hemagglutination and save the red blood cells (RBC) infusion, from a financial point of view than the B group less treatment costs per capita. Conclusion: The DCR combined with equal proportion of blood transfusions has good curative effect on multiple trauma concurrent with ATC.