机采血小板联合冷沉淀输注对大出血患者凝血功能的影响  

作　　者：王敬波 胡旭梅 王伟 吴伟[2] 

机构地区：[1]河北省香河县人民医院儿科,065400 [2]河北省石家庄市第一医院心脏大血管外科,050011

出　　处：《浙江临床医学》2015年第6期870-871,共2页Zhejiang Clinical Medical Journal

摘　　要：目的：了解机采血小板联合冷沉淀输注对大出血患者凝血功能的影响。方法选取2010年1月至2014年9月进行大量输血治疗的急性大出血患者122例，将单独输注机采血小板的患者设为血小板组，单独输注冷沉淀的患者设为冷沉淀组，机采血小板联合输注冷沉淀者设为联合组。观察3组患者输血前后凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）、血小板（PLT）等指标的变化情况。结果3组患者输注前凝血功能指标比较，差异无统计学意义（P〉0.05）。联合组患者血小板联合冷沉淀输注后，PT、APTT、TT较输注前明显缩短（P〈0.05），FIB、PLT较输注前明显增加，差异有统计学意义（P〈0.05）；联合组与机采血小板输注组比较，PT、APTT、TT明显缩短，FIB明显增加，差异有统计学意义（P〈0.05），与冷沉淀组比较，PT、APTT、TT明显缩短，PLT明显增加，差异有统计学意义（P〈0.05）。结论机采血小板联合冷沉淀输注可显著提高大量输血患者血液循环中凝血物质的含量，缩短凝血时间，可更好的避免凝血功能紊乱。与单独输注机采血小板或冷沉淀相比，具有更显著的止血效果。Objective To understand the impacts of joint infusion of apheresis platelet and cryoprecipitate on blood coagulation function in patients with massive blood transfusion. Methods 122 cases of acute bleeding patients for massive blood transfusion were choosed as the research object in our hospital between January 2010 and September 2014. The patients with only infusion of apheresis platelet were set as the platelet group,only infusion of cryoprecipitate as the cryoprecipitate group,and joint infusion of apheresis platelet and cryoprecipitate as the joint group. Prothrombin time（PT）,Activated partial prothrombin time（APTT）,Thrombin time（TT）,Fibrinogen（FIB）and platelet（PLT）before and after blood transfusion were observed in three groups. Results Blood clotting indexes before blood transfusion were compared in three groups,there were no statistically significant difference（P〉0.05）. PT,TT and APTT after joint infusion were significantly shortener than those before infusion in the joint group（P〈0.05）.FIB and PLT were significantly increased after the infusion in the joint group（P〈0.05）. PT,APTT and TT were shortened obviously,FIB increased significantly in the joint group,and were compared with those in the platelet group,the difference were statistically significant（P〈0.05）,compared with cryoprecipitate group,PT,APTT, TT shortened obviously,PLT increased significantly,the difference were statistically significant（P〈0.05）. Conclusion Joint infusion of apheresis platelet and cryoprecipitate could raise coagulation material content among the blood circulation in patients with massive blood transfusion and shorten the clotting time, to avoid blood coagulation disorder with a more significant hemostatic effect.

关 键 词：血小板 冷沉淀 联合输注 大量输血 凝血 

分 类 号：R457[医药卫生—治疗学]