Abstract:

AIM:To investigate the clinical efficacy of human fibrinogen(FIB) in patients with emergency traumatic coagulopathy and the related factors in patients with traumatic coagulopathy. METHODS:One hundred patients with severe trauma admitted to our hospital from June 2015 to June 2018 were included in the study. According to whether the traumatic coagulopathy，they were classified into coagulopathy group (80 cases) and non-coagulopathy group (20 cases). The acute physiology and chronic health evaluation II (APACHE II) and the injury severity score (ISS) of the first 24 h after admission，hypothermia and hypoperfusion incidence were compared between the patients in the coagulopathy group and the non-coagulopathy group. Logistic multivariate regression analysis was used to analyze the related factors of traumatic coagulopathy in patients with severe trauma. Eighty patients with traumatic coagulopathy were randomly divided into observation group (40 cases) and control group (40 cases). The control group was given conventional medical treatment. The observation group was given human fibrinogen based on the control group. The coagulation function indexes and the clinical blood volume，hospitalization time and mortality of of the observation group and the control group were compared.RESULTS:Compared with before treatment，the prothrombin time (PT)，activated partial thromboplastin time (APTT) and D-dimer levels were decreased，the level of fibrinogen (FIB) was significantly increased in the observation group and the control group after treatment(P<0.05). The red blood cell(RBC) infusion volume，fresh frozen plasma(FFP) infusion volume，intensive care unit(ICU) time and mortality rate of the observation group were significantly lower than those in the control group(P<0.05).Traumatic coagulation patients with PT>18 s (r=0.623，P=0.024)，APTT>60 s (r=0.722，P=0.018)，thrombin time(TT>15 s (r=0.719，P=0.033) were positively correlated with ISS scores. Base deficit(BD)≥6 (OR=3.678，95%CI=1.065-9.417)，Glasgow coma scale(GCS)≤8 (OR=5.299，95%CI=1.122-8.711) and platelet(PLT) count (OR=0.982，95%CI=0.971-0.996) were the independent predictors of traumatic coagulopathy in patients with severe trauma.CONCLUSION:Human FIB can effectively improve the coagulation function of patients with traumatic coagulopathy，reduce the mortality rate，shorten the ICU time，and there is certain correlation between traumatic coagulopathy and trauma severity，combined with shock，hypothermia and severe craniocerebral injury.

Key words: fibrinogen, traumatic coagulopathy, coagulation, efficacy, related factors