ABSTRACT
【Objective】 To investigate the causes of abnormal decrease in maximum amplitude(MA) of thromboelastography(TEG) and its effect on prognosis by monitoring the changes of coagulation-related indexes in emergency trauma patients. 【Methods】 A total of 319 cases of trauma patients admitted to our hospital from September 2020 to September 2023 were retrospectively analyzed, and the coagulation-related indexes of 0 h and 24 h after admission were observed. According to the MA results, they were divided into normal MA group(>50 mm) and reduced MA group(≤50 mm) to compare the hemoglobin(Hb), platelets count(Plt), activated partial thromboplastin time(APTT), prothrombin time(PT), fibrinogen(Fib), thrombin time(TT), D-dimer(D-D), coagulation reaction time(R), clot formation kinetics(Angle), 30 min clot dissolution rate(Ly30), MA, thrombine-antithrombin complex(TAT) and plasminase-α2 plasminase inhibitor complex(PIC). The correlation between MA and fibrinolysis indexes in 319 trauma patients was analyzed. According to whether tranexamic acid(TXA) was used, the reduced MA group was divided into a TXA group and a non-drug group. The differences in the change of the above coagulation-related indexes, mortality rate and changes in blood product dosage were compared between the two groups. 【Results】 Compared with the normal MA group, Hb, Plt, Fib, diastolic blood pressure and GCS scores decreased, while heart rate, ISS score and mortality increased significantly in the reduced MA group(P0.05). The mortality rate in the TXA group was reduced significantly(P<0.05). 【Conclusion】 Hyperfibrinolysis may be an important factor in the abnormal decrease of MA in emergency trauma patients. Treatment with TXA can improve its effect on MA, and reduce the transfusion of blood products and the patient mortality.
ABSTRACT
Objective To observe the dynamic distribution of the extravasated Evans Blue (EB) dye points (neurogenic inflammatory response) at the skin after acute gastric mucosal injury (AGMI) and its relation to the related regular acupoints in the locations in rats. Methods A total of 70 Wistar rats were randomized into normal control (n=10),normal saline (n=10),and AGMI (n=50) groups. The AGMI group was further divided into 5 h,2 d,3 d,4 d and 5 d subgroups with 10 rats in each. AGMI model was duplicated by intragastric perfusion of diluted hydrochloric acid (HCl,0.5 mol/L). Evans Blue Dye (50 mg/kg,50 mg/mL in 0.9% saline) was given to the rats before AGMI modeling. The plasma extravasated EB points at the skin of the whole body were observed after removal of the hair. Results The extravasated EB points presented a nerve-segmental distribution,with the proportion of the points in the location being 47.5% for "Geshu" (BL 17),58.82% for "Jizhong" (GV 6),88.23% for "Pishu" (BL 20),82.35% for "Weishu" (BL 21),17.64% for "Zhongwan" (CV 12),and 5.88% for "Shangwan" (CV 13),respectively. The plasma extravasation of EB seldom appeared in normal rats and only fewer points were found in rats accepted administration of 0.9% saline. Significant differences were found between model and normal control groups,and between model and normal saline groups in the numbers of the extravasated EB points (P