尹进南　岳茂兴　李瑛

[摘要] 目的 探讨20AA复方氨基酸联用维生素B6新疗法治疗创伤性凝血病（TIC）的临床有效性。 方法 选取江苏大学附属武进医院2006年1月～2015年12月收治的30例TIC患者作为研究对象，将2006年1月～2008年12月收治的18例患者设为对照组，仅常规实施损伤控制性外科及综合对症处理；将2009年1月～2015年12月收治的12例患者设为观察组，在接受损伤控制性外科处理及综合治疗基础上，加用20AA复方氨基酸联用维生素B6的新疗法。比较两组患者输血量、死亡率（48 h内死亡率和总死亡率）和住院时间。 结果 对照组与观察组TIC患者入院时基础情况比较，差异无统计学意义（P > 0.05）。经过相应救治后，观察组输血量明显低于对照组（P < 0.05）；观察组48 h内死亡率和总死亡率均低于对照组，差异有统计学意义（P < 0.05）；观察组住院时间低于对照组，差异有统计学意义（P < 0.05）。 结论 TIC采用损伤控制性外科措施及综合对症处理基础上，及早应用20AA复方氨基酸联用维生素B6新疗法能加快止血、缩短住院时间、降低死亡率，对其治疗起到积极作用。

[关键词] 创伤性凝血病；20AA复方氨基酸；维生素B6

[中图分类号] R641 [文献标识码] A [文章编号] 1673-7210（2016）12（c）-0182-04

[Abstract] Objective To explore the curative effect of 20AA compound amino acid combined with vitamin B6 in treatment of trauma-induced coagulopathy （TIC）. Methods From January 2006 to December 2015， 30 patients with TIC treated at Wujin Hospital Affiliated to Jiangsu University were selected. 18 patients treated from January 2006 to December 2008 were divided into control group， which were received the routine damage control surgery and comprehensive symptomatic treatment. Then 12 patients treated from January 2009 to December 2015 were divided into observation group， which were additionally received the new therapy of 20AA compound amino acid combined with vitamin B6. The blood transfusion volume， mortality （mortality within 48 h and the total mortality） and length of hospital stay of two groups were compared. Results The basic conditions of two groups had no significant difference （P > 0.05）. After different treatment， the blood transfusion volume in the observation group was less than that in the control group （P < 0.05）. The mortality within 48 h and the total mortality in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. The length of hospital stay in the observation group was shorter than that in the control group， the difference was statistically significant （P < 0.05）. Conclusion On the basis of the damage control surgery and comprehensive symptomatic treatment， the new therapy of 20AA compound amino acid combined with vitamin B6 can accelerate hemostasis， reduce the length of hospital stay and mortality， which plays a positive role for the treatment of TIC.

[Key words] Trauma-induced coagulopathy； 20AA compound amino acid； Vitamin B6

創伤性凝血病（trauma-induced coagulopathy，TIC）是在严重创伤或大手术打击下，机体出现以凝血功能障碍为主要表现的临床病症，是世界性治疗难题[1-2]。创伤后患者的早期死亡与无法控制的出血及失血后凝血功能障碍的发生有关[3]，严重创伤患者出现凝血病后死亡率可高达80%[4]。近年来，人们逐渐认识到TIC在创伤早期所起的巨大作用。及早诊断和积极处理TIC有助于更好地控制出血，是降低创伤死亡率的关键[5]。笔者及本治疗团队于2009年起，在实施损伤控制性外科的基础上采用岳茂兴教授专利处方（ZL2010 1 0248451.9）20AA复方氨基酸联用维生素B6的新疗法对TIC患者进行治疗，取得了较好效果，现报道如下：

1 资料与方法

1.1 一般资料

以江苏大学附属武进医院（以下简称“我院”）2006年1月～2015年12月收治的30例TIC患者（男11例，女19例）作为研究对象，进行回顾性研究。纳……