不就是TXA和FC同时给予吗？

An European expert meeting suggested 1 g TXA as soon as possible and within 3 h of trauma followed by FC, blindly while awaiting fibrinogen level results, and finally PCC if bleeding continues, fibrinogen level is normalized, and clotting time is prolonged per VET [3].

一次欧洲专家会议建议在创伤后3小时内尽快给予1 g TXA（氨甲环酸），然后无论什么值在等待纤维蛋白原检测水平时给予用FC（纤维蛋白原浓缩物），最后如果出血持续、纤维蛋白原水平正常、根据VET凝血时间延长则再给予PCC（凝血酶原复合物浓缩物）。

我理解的对吗？

纤维蛋白原检测水平又不需要等结果，那不就是TXA（氨甲环酸）和FC（纤维蛋白原浓缩物）同时给予吗？

我把参考文献放上去

We believe a step-wise approach to the treatment for trauma-related bleeding allows for individualised therapy, and avoids overtreatment and unnecessary allogeneic transfusion. Therefore, we suggest the initial administration of TXA, followed by FCH, and lastly PCC if bleeding continues (Fig. 1), with weight-adjusted doses if possible. However, we acknowledge that the recommendation for the use of PCC in a patient with a normal fibrinogen level (> 1.5 g/L), but with continued bleeding and a prolonged clotting time is a weak recommendation, and is listed as a second-line treatment recommendation in the fifth European trauma guidelines (Grade 2C) [10]. PCC recommendations also vary by country, as described below and in Table 1; we recommend that PCC should be administered only in the presence of a prolonged clotting time.

我们认为创伤相关出血治疗的逐步方法允许个体化治疗，并避免过度治疗和不必要的同种异体输血。因此，我们建议初始给予TXA，然后给予FCH，如果出血持续，最后给予PCC（图1），如果可能，使用根据体重调整的剂量。然而，我们承认，对于纤维蛋白原水平正常(> 1.5 g/L)但伴有持续出血和凝血时间延长的患者，使用PCC的建议较弱，在第五版欧洲创伤指南（2 C级）中被列为二线治疗建议[10]。PCC建议也因国家而异，如下文和表1所述；我们建议仅在凝血时间延长的情况下给予PCC。