损伤控制复苏在急性创伤性凝血病救治中的临床研究

摘要

Objective To investigate the clinical value of damage control resuscitation( DCR)in the treatment of patients with acute traumatic cogulopathy( ATC). Method 124 patients with ATC were divided into three groups,two DCR groups and one control group. The DCR group 1 received the ratio of 3 packed red blood cells( PRBC)to 1 frozen fresh plasma( FFP)and the DCR group 2 received the ra-tio of 1 PRBC to 1 FFP. The control group only received PRBC. 4d PRBC dosage,prognostic indicators,and coagulation indicators were compared among the three groups. Results After receiving DCR treatment,the patients with ATC needed less PRBC,had better clotting fuc-tion and prognostic indicators,with less DIC morbidity and mortality. The 1:1 group also had better prognostic indicators than the 3:1 group. Conclusion The DCR can improve the prognosis of ATC patients,and the resuscitation fluid is recommended as the ratio of 1:1.%目的：研究损伤控制复苏（ damage control resuscitation，DCR）在急性创伤性凝血病（ acute tramautic coagulopathy， ATC）患者中的临床疗效。方法：将ATC患者124例分为三组，其中两组为DCR组，分别以3：1、1：1比例的红悬液（ PRBC）和冰冻血浆（ FFP）为主要复苏液体，另一组为对照组，以PRBC为主要复苏液体，比较三组4d内PRBC用量、预后指标及凝血指标。结果：采用DCR救治ATC患者疗效良好，PRBC用量少，凝血功能恢复好，DIC发病率及病死率显著降低，与对照组比较，差异有统计学意义，且1：1组各项指标及预后优于3：1组。结论：采用DCR能够快速改善ATC凝血指标，改善患者预后，提高生存率，推荐复苏液比例为1：1。