Winearls James, Campbell Don, Hurn Catherine, Furyk Jeremy, Ryan Glenn, Trout Melita, Walsham James, Holley Anthony, Shuttleworth Megan, Dyer Wayne, Keijzers Gerben, Presneill Jeff, Fraser John F, Wullschleger Martin
Gold Coast University Hospital, Australia; School of Medical Sciences, Griffith University, Australia; School of Medicine, University of Queensland, Australia.
Gold Coast University Hospital, Australia.
Injury. 2017 Feb;48(2):230-242. doi: 10.1016/j.injury.2016.12.012. Epub 2016 Dec 26.
Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes. Hence, it has been postulated that early fibrinogen replacement in severe traumatic haemorrhage may improve outcomes, although, to date there is a paucity of high quality evidence to support this hypothesis. In addition there is controversy regarding the optimal method for fibrinogen supplementation. We review the current evidence regarding the role of fibrinogen in trauma, the rationale behind fibrinogen supplementation and discuss current research.
严重创伤情况下的出血与显著的发病率和死亡率相关。人们越来越意识到纤维蛋白原在创伤性出血中所起的重要作用。在严重创伤中，纤维蛋白原水平会急剧下降，由此产生的低纤维蛋白原血症与不良预后相关。因此，有人推测在严重创伤性出血中早期补充纤维蛋白原可能会改善预后，不过，迄今为止，缺乏高质量的证据来支持这一假设。此外，关于补充纤维蛋白原的最佳方法也存在争议。我们回顾了关于纤维蛋白原在创伤中的作用的现有证据、补充纤维蛋白原的理论依据，并讨论了当前的研究。
