肝硬化患者血浆输注临床分析  

Usage of plasma in patients with hepatic cirrhosis

作　　者：王震[1] 陈秉宇[1] 杜垚强 潘红英[3] 蒋璐茜[1] 沈健[1] 李育[1] 

机构地区：[1]浙江省人民医院输血科,浙江杭州310014 [2]温州医科大学检生学院 [3]浙江省人民医院感染科,浙江杭州310014

出　　处：《全科医学临床与教育》2015年第3期248-251,共4页Clinical Education of General Practice

基　　金：浙江省中医药科学研究基金(2014ZB007);浙江省中医药优秀青年人才基金(2014ZQ005)

摘　　要：目的：探讨肝硬化患者血浆输注的疗效。方法收集近两年所有肝硬化住院患者病历资料，筛选出输注血浆治疗的223例患者，分析其血浆输注的病因，血浆输注前后的凝血功能和肝生化指标的改变。结果肝硬化患者血浆输注主要病因为乙肝所致肝硬化。患者输注血浆后凝血功能显著改善，凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、国际标准化比值（INR）显著下降，差异有统计学意义（t分别=2.16、2.42、2.15，P均＜0.05）。同时患者输注血浆后肝功能相关生化指标明显好转，白蛋白（Alb）显著上升，谷草转氨酶（AST）、谷氨酰转肽酶（GGT）、血清肌酐（Scr）、总胆红素（TBIL）（初始TBIL 34～51μmol/L组）显著下降，差异有统计学意义（t分别=2.70、2.31、2.15、2.51、1.74，P均＜0.05）。结论肝硬化患者输注血浆后凝血和肝功能相关生化指标得到改善，综合评价血浆输注的疗效可同时考虑凝血和肝功能相关生化指标。Objective To investigate clinical effect of the plasma transfusion for hepatic cirrhosis patients. Methods Medical records of the hepatic cirrhosis patients in recent two years were collected and 223 hepatic cirrhosis patients that transfused with plasma were selected. Reason of plasma transfusion was analyzed and the change indexes of blood coagula-tion and liver function before and after plasma transfusion were monitored. Results The hepatic cirrhosis caused by hep-atitis B virus was the main reason for plasma transfusion in cirrhosis patients. The blood coagulation function of cirrhosis patients were significantly improved after plasma transfusion, the indexes of PT, APTT and INR decreased significantly, and the differences were statistically significant （t=2.16,2.42,2.15, P〈0.05）. In the same time, the biochemical indexes of liver were significantly improved, such as Alb increased significantly, AST, GGT, Scr and TBIL （Initial TBIL is 34～51μmol/L） decreased significantly（t=2.70,2.31,2.15,2.51,1.74,P〈0.05）. Conclusion After plasma transfusion, the blood coagulation indexes and other biochemical indexes relating to liver function of the hepatic cirrhosis patients are improved. Both blood coagulation and biochemical indexes should be considered when evaluating the effect of plasma transfusion in cirrhosis patients.

关 键 词：肝硬化 血浆输注 凝血功能 生化指标 

分 类 号：R575.2[医药卫生—消化系统]