关键词:

凝血功能障碍, 颅脑创伤, 氨甲环酸, 疗效

Abstract:

Objective　To explore the effect of cryoprecipitate combined with tranexamic acid for patients with coagulopathy caused by cranial trauma. Methods　From January 2022 to December 2023, 118 patients with coagulopathy caused by cranial trauma treated at Chang'an Hospital were selected for the randomized controlled trial, and were divided into a control group and an experimental group by the random number table method, with 59 cases in each group. There were 29 males and 30 females in the control group; they were (42.35±12.58) years old. There were 31 males and 28 females in the experimental group; they were (43.27±11.94) years old. The control group were treated with cryoprecipitate, and the experimental group with cryoprecipitate and tranexamic acid. The coagulation function [thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), and platelet count (PLT)], serum levels of growth factors [transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bF-GF)], levels of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8)], levels of fibrinolysis indicators [fibrin degradation products (FDP), and D-dimer (D-D)], and incidence rates of complications were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　Before the treatment, there were no statistical differences in the coagulation function and levels of growth factors, inflammatory factors, and fibrinolysis indicators between the two groups (all P>0.05). After 3 days' treatment, the TT, PT, and APTT in the experimental group were shorter than those in the control group [(14.87±2.46) s vs. (17.01±2.81) s, (14.35±2.68) s vs. (16.99±2.93) s, and (37.01±5.41) s vs. (42.85±5.47) s]; the levels of Fg, PLT, TGF-β1, VEGF, bF-GF, and IL-8 in the experimental group were higher than those in the control group [(1.68±0.29) g/L vs. (1.42±0.24) g/L, (89.77±6.46)×10⁹/L vs. (79.00±6.81)×10⁹/L, (16.65±3.92) ng/L vs. (13.16±3.53) ng/L, (39.77±5.84) μg/L vs. (35.31±5.58) μg/L, (27.74±3.62) μg/L vs. (23.32±3.15) μg/L, and (21.78±4.64) μg/L vs. (18.47±3.90) μg/L]; the levels of TNF-α, IL-6, FDP, and D-D in the experimental group were lower than those in the control group [(2.03±0.27) μg/L vs. (2.84±0.21) μg/L, (2.85±0.73) μg/L, vs. (3.91±0.66) μg/L, (2.75±0.32) mg/dL vs. (5.47±0.82) mg/dL, and (0.97±0.28) mg/L vs. (1.65±0.34) mg/L]; there were statistical differences (t=4.401, 5.107, 5.831, 5.305, 8.813, 5.082, 4.241, 7.075, 4.195, 18.189, 8.273, 23.736, and 11.859; all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the experimental group and the control group [3.39% (2/59) vs. 10.17% (7/59); χ²=2.145; P=0.143]. Conclusion　Cryoprecipitate combined with tranexamic acid for patients with coagulopathy caused by cranial trauma is effective, and can improve their coagulation markers and levels of growth factors, reduces inflammatory responses, and decrease the occurrence of adverse reactions.

Key words:

Coagulopathy, Cryoprecipitate, Cranial trauma, Treatment effect