冷沉淀和血小板联合治疗创伤失血性休克临床研究(附87例分析)  

Effect of platelets and cryoprecipitation on the exsanguine shock patients caused by severe trauma(87 cases)

作　　者：林绍彬[1,2] 张进萍[1,2] 熊圣仁[1,2] 宋霖[1,2] 陈卫红[1,2] 蒋小玲[1,2] 王颖[1,2] 

机构地区：[1]福建医科大学教学医院 [2]福州市第二医院,福州350007

出　　处：《福建医药杂志》2010年第2期1-2,共2页Fujian Medical Journal

基　　金：福州市科技计划项目(2007-S-121)

摘　　要：目的研究早期、快速联合输注冷沉淀和单采血小板对创伤失血性休克的临床效果。方法将87例创伤失血性休克患者随机分为A、B、C3组,每组各29例。3组均采取常规疗法,包括给氧、补液、固定、止血、纠正酸碱平衡、输洗涤红细胞悬液等抗休克措施,在此基础上,A组采用联合输冷沉淀10～30单位和单采血小板1～3个治疗量;B组单纯输单采血小板1～3个治疗量;C组单纯输冷沉淀10～30单位。3组均在治疗前1h及治疗后2～12h分别检测其凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FBG)、血小板计数(PLT)的变化。结果A、B、C3组输注后PT、APTT、TT较输注前缩短,FBG、PLT较输注前增加,其差异均具有统计学意义(P<0.01);输注后A组TT、PT、APTT小于B、C2组,FBG、PLT大于B、C两组,其差异均具有统计学意义(P<0.05)。结论在创伤失血性休克治疗中,早期、快速、联合输注冷沉淀和单采血小板比单独输注冷沉淀或单采血小板有更好的疗效。Objective To discuss the effect of platelets and cryoprecipitation in the treatment of bleeding caused by severe trauma. Methods 87patients with severe trauma were randomly divided into the platelets and cryoprecipitation group （group A）, the platelets Group （Group B） and cryoprecipitation Group （Group C）. The three groups were initially treated with sup- plemental oxygen, crystalloid, colloid, or blood product. Once circulating volume have been restorted, patients in group A were infused with frozen platelets 1--3 unit and cryoprecipitation 10--30 unit respectively. The Prothrombin time （PT）, acti- vated partial thromboplasting time （APTT）, thrombin time （TT）, fibrinogen （FBG） and platetet （PLT） were checked one hour before transfusion and 2--12 h after transfusion. Results In the three groups, the levels of PT, APTT, TT were shortened significantly （P〈0. 01 ） and FBG, PLT were increased markedly （P〈0. 01） after transfusion. The levels of PT, APTT, TT after transfusion of group A were lower significantly （P^0.05） than those of group B＆C; The levels of FBG, PLT after transfusion of group A were higher significantly （P〈0.05） than those of group B＆C. Conclusion The transfusion of platelets and eryoprecipitation has significant effect on the exsanguine shock patients caused by severe trauma.

关 键 词：血小板 冷沉淀 失血性休克 凝血因子 

分 类 号：R641[医药卫生—外科学]