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目的探讨损伤控制性复苏方案院前救治重症创伤性凝血病的效果及对患者凝血功能的影响,为临床治疗提供参考。方法选取2012年12月至2014年12月湖北省当阳市人民医院诊治的重症创伤性凝血病患者320例,根据复苏方法随机分为观察组和对照组,每组160例。对照组患者给予传统的复苏方案进行院前救治,观察组患者给予损伤控制性复苏方案救治。观察并记录两组患者在相应救治方案干预后的低体温时间、凝血功能障碍时间、酸中毒时间、住院时间及死亡率。结果两组患者在相应复苏方案干预后,观察组患者的低体温时间、凝血功能障碍时间、酸中毒时间分别为(9.3±1.2)、(13.5±5.6)、(15.4±4.7)h,显著低于对照组患者的(20.2±1.9)、(31.3±12.2)、(30.1±5.8)h,差异有统计学意义(t值依次为61.354、16.773、24.901,均P<0.05);观察组患者的住院时间、疾病死亡率均低于对照组,差异有统计学意义(t=13.022、χ~2=6.850,均P<0.05)。结论重症创伤性凝血病患者给予损伤控制性复苏方案院前救治,可以显著提高患者的治疗效果,且安全有效,值得临床推广。
Objective To investigate the effect of premedication for the treatment of severe traumatic coagulopathy in patients undergoing controlled reinstatement of injury and its effect on the coagulation function of patients and provide reference for clinical treatment. Methods 320 patients with severe traumatic coagulopathy diagnosed and treated in Dangyang People’s Hospital of Hubei Province from December 2012 to December 2014 were randomly divided into observation group and control group according to the method of resuscitation, with 160 cases in each group. Patients in the control group were given pre-hospital treatment with traditional recovery plan and patients in observation group with control and recovery program. Observe and record the hypothermia time, coagulation dysfunction time, acidosis time, hospitalization time and mortality rate of the two groups after the corresponding treatment intervention. Results The hypothermia time, clotting dysfunction time and acidosis time in the two groups were (9.3 ± 1.2), (13.5 ± 5.6) and (15.4 ± 4.7) h, respectively, after intervention of the corresponding resuscitation regimen. (20.2 ± 1.9), (31.3 ± 12.2) and (30.1 ± 5.8) h in the control group (t = 61.354, 16.773 and 24.901 respectively, all P <0.05) Hospitalization time and disease mortality were lower than the control group, the difference was statistically significant (t = 13.022, χ ~ 2 = 6.850, all P <0.05). Conclusion Patients with severe traumatic coagulopathy given premedictive treatment of injury-controlled resuscitation program can significantly improve the therapeutic effect of patients, and safe and effective, worthy of clinical promotion.