产后大出血大量输血时浓缩红细胞与血浆输注比例对凝血功能的影响  

Effect of proportion of concentrated red blood cells to plasma during massive blood transfusion on coagulation function of patients with postpartum hemorrhage

作　　者：李炳法[1] 刘永云[1] 张宝凯[1] 

机构地区：[1]山东省滨州市人民医院输血科,256610

出　　处：《中国妇幼保健》2014年第15期2319-2321,共3页Maternal and Child Health Care of China

基　　金：山东省科技攻关计划资助项目〔2011AA401B21〕

摘　　要：目的:研究不同比例的浓缩红细胞与血浆输注对产后大出血患者凝血功能的影响。方法:将120例产后大出血患者作为研究对象,随机分为A、B、C 3组,每组各40例;A组浓缩红细胞与血浆配比为1∶8;B组1∶3;C组1∶1;比较3组患者输血前后的凝血酶原时间、凝血酶时间以及凝血活酶部分活化时间的变化;测定并比较3组患者输血前后血红蛋白、纤维蛋白原以及血小板含量。结果:与患者产前相比,输血后,A组凝血酶各时间指标延长,血液蛋白含量及血小板数量降低;B组凝血酶各时间指标略有延长,血液蛋白含量及血小板数量降低;C组上述指标均无变化;三组间比较差异具有统计学意义(P<0.01)。结论:浓缩红细胞较少时,不利于产后大出血患者凝血功能的恢复,凝血酶各时间指标延长或血液蛋白含量及血小板数量降低,当浓缩红细胞与血浆比例达到1∶1时,患者凝血功能恢复良好。Objective： To research the effects of different proportions of concentrated red blood cells to plasma during massive blood transfusion on coagulation function of patients with postpartum hemorrhage. Methods： One hundred and twenty patients with postpar tum hemorrhage were selected as study objects, and then they were randomly divided into group A, group B and group C, 40 patients in each group; the proportions of concentrated red blood cells to plasma during massive blood transfusion in group A, group B and group C were 1 ： 8, 1 ： 3 and 1 ： 1, respectively ; the changes of prothrombin time, thrombin time and thrombin activated partial time in the three groups were com- pared; the contents of hemoglobin, fibrinogen and platelet before and after blood transfusion in the three groups were detected and compared. Results ： Compared with prenatal patients, after blood transfusion, the thrombin time indexes in group A prolonged, the contents of hemoglo- bin, fibrinogen and platelet decreased ; the thrombin time indexes in group B prolonged slightly, the contents of hemoglobin, fibrinogen and platelet decreased; the above- mentioned indexes in group C didni change, there were statistically significant differences among the three groups （P 〈 0. 01 ） . Conclusion ： Low concentrated red blood cells content is not beneficial to recovery of coagulation function in patients with postpartum hemorrhage, the thrombin time indexes prolong and the contents of hemoglobin, fibrinogen and platelet decrease; when the proportion of concentrated red blood cells to plasma during massive blood transfusion reaches 1 ： 1, the recovery of coagulation function in these patients is good.

关 键 词：产后大出血 浓缩红细胞 血浆 凝血功能 

分 类 号：R714.461[医药卫生—妇产科学]