摘要
目的:探讨大量输血对创伤性失血患者凝血功能与血液指标的影响。方法:选取2019年7月~2020年7月期间52例创伤性失血患者,均实施大量输血治疗,同时根据患者病情实施不同的输血方案。A组:每1U悬浮红细胞匹配100 mL血浆,比例1∶1;B组:悬浮红细胞∶血浆=1.5∶1;C组:悬浮红细胞∶血浆=2∶1。所有患者均输注>8U的红细胞。观察并比较三组输血前、输血24 h后的凝血功能指标[凝血酶时间(thrombin time,TT)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)]和患者血液指标[红细胞压积(hematocrit,Hct)、血红蛋白(hemoglobin,Hb)、血小板计数(blood platelet,Plt)]。结果:经大量输血治疗(输注悬浮红细胞)后,患者TT、PT、APTT较输血前明显延长,FIB较输血前显著降低(P<0.05),同时应用不同输血方案后,A组、B组各指标组间比较差异无统计学意义(P>0.05),而C组较A、B组APTT、PT明显高,FIB明显降低(P<0.05)。同时大量输血后,患者Hct、Hb指标较输血前均有所改善,而Plt指标较输血前明显降低(P<0.05);应用不同输血方案,A、B组各指标组间比较差异无统计学意义(P>0.05),C组Plt明显低于A组(P<0.05)。结论:创伤性失血患者大量输血过程中发生凝血功能紊乱的风险较高,应严密监测患者凝血功能及血液指标,及时提供冷沉淀、血小板等血液成分,以防凝血功能异常而引起出血。
Objective:To explore the effect of massive blood transfusion on coagulation function and blood indexes in patients with traumatic blood loss.Methods:A total of 52 patients with traumatic blood loss from July 2019 to July 2020 were selected and treated with massive blood transfusion.At the same time,different blood transfusion schemes were implemented according to the patient's condition.Group A:100 mL plasma per 1U suspended red blood cells,ratio 1∶1;group B:suspended red blood cells∶plasma=1.5∶1;group C:suspended red blood cells∶plasma=2∶1.All patients were infused with>8U red blood cells.The indexes of coagulation function[thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)]and blood indexes[hematocrit(Hct),hemoglobin(Hb),blood platelet(Plt)]were observed and compared in the three groups before and 24 hours after blood transfusion.Results:After massive blood transfusion(infusion of suspended red blood cells),TT,PT and APTT were significantly prolonged and FIB was significantly decreased(P<0.05)At the same time,after massive blood transfusion,Hct and Hb indexes were improved,while PLT index was significantly lower than those before blood transfusion(P<0.05).With different blood transfusion schemes,there was no significant difference in each index between groups A and B(P>0.05).Compared with group A and group B,APTT and PT in group C were significantly higher,FIB was significantly lower(P<0.05).At the same time,after massive blood transfusion,Hct and Hb indexes were improved,while Plt index was significantly lower than that before blood transfusion(P<0.05).With different blood transfusion schemes,there was no significant difference in each index between groups A and B(P>0.05),and Plt in group C was significantly lower than that in group A(P<0.05).Conclusion:The risk of coagulation disorders in patients with traumatic blood loss during massive blood transfusion is high.Coagulation function and blood indexes of patients should be closely monitored,and blood components such as cold precipitation and platelets should be provided in time to prevent bleeding caused by abnormal coagulation function.
作者
刘敏静
杜思远
林小燕
曾凤群
李健茹
LIU Minjing;DU Siyuan;LIN Xiaoyan;ZENG Fengqun;LI Jianru(Department of Blood Transfusion,Jiangmen Xinhui District People’s Hospital,Jiangmen 529199,China;Department of Laboratory Medicine,Jiangmen Xinhui District People’s Hospital)
出处
《包头医学院学报》
CAS
2022年第8期32-35,46,共5页
Journal of Baotou Medical College
基金
江门市卫生健康局科研项目(21A054)
关键词
创伤性失血
输血
凝血功能
血液指标
悬浮红细胞
血浆
Traumatic Blood Loss
Massive Blood Transfusion
Coagulation Function
Blood Index
Red Blood Cells Suspension
Plasma
