血小板计数和血清钙离子水平与大量输血后患者凝血功能紊乱关系的研究  

Research on the Relationship of PLT and Ca^(2+) Levels in Patients with Coagulation Function Dysfunction after Massive Transfusion

作　　者：赵子贤[1] 李娟红[1] 陈锦源[1] 汤翠霞 陈世豪[1] 李健茹[1] 

机构地区：[1]南方医科大学附属新会医院,广东江门529100

出　　处：《中国医学创新》2017年第2期133-136,共4页Medical Innovation of China

摘　　要：目的:探讨血小板计数(PLT)、血清钙离子(Ca^(2+))与大量输血后患者凝血功能的关系。方法:选取2012年3月-2015年3月本院输血治疗的104例大出血患者为研究对象,输血量1000~2000 m L的50例大出血患者为输血组,输血量≥2000 m L的54例大出血患者为大量输血组,另选54例健康检查者为对照组。两组输血1 h后,分别检测各组的PLT和Ca^(2+)浓度的变化情况。结果:与对照组比较,输血组和大量输血组PLT和Ca^(2+)浓度均明显下降,差异均有统计学意义(P<0.05);输血组和大量输血组PLT和Ca^(2+)浓度比较,差异均无统计学意义(P>0.05)。通过相关分析得出,在输血组和大量输血组中PLT和Ca^(2+)均无相关性(r=0.058,P=0.512;r=0.061,P=0.384)。通过Logistic回归分析得出,PLT、Ca^(2+)浓度与大量输血后患者出现凝血功能紊乱独立相关。(OR=0.134,P=0.019;OR=0.140,P=0.008)。与输血组相比,大量输血组的低血小板血症和低血钙血症的发生率明显升高,差异均有统计学意义(字2=36.563,P=0.000;字2=35.884,P=0.000)。结论:PLT和Ca^(2+)浓度可作为大量输血后患者出现凝血功能紊乱的风险评估指标。Objective：To investigate the relationships of PLT and Ca^2＋ levels in patients with coagulation function dysfunction after massive transfusion Method：A total of 104 patients with hemorrhage for blood transfusion treatment were chosen as the research objects,among them 50 cases for 1000 to 2000 m L as blood transfusion group and 54 cases for 2000 m L or greater of blood transfusion as massive blood transfusion group.In addition,54 healthy peoples were chosen as the control group.After one hour blood transfusion,the change of serum PLT and Ca^2＋ were tested in two groups.Result：Compared with the control group,PLT and Ca^2＋ levels decreased significantly in blood transfusion group and massive blood transfusion group（P〈0.05）.No statistical significance was found between blood transfusion group and massive blood transfusion group（P〉0.05）.PLT and Ca^2＋ levels in blood transfusion group and massive blood transfusion group had no correlation（r=0.058,P=0.512;r=0.061,P=0.384）.By the Logistic regression analysis,PLT and Ca^2＋ levels were correlated independently with coagulationfunction dysfunction（OR=0.134,P=0.019;OR=0.140,P=0.008）.Compared with blood transfusion group,the low blood platelet and hypocalcaemia were more likely to appear in massive blood transfusion group（x^2=36.563,P=0.000;x^2=35.884,P=0.000）.Conclusion：Plasma PLT and Ca^2＋ levels can be used in risk assessment of coagulation function dysfunction.

关 键 词：血小板计数 钙离子 大量输血 凝血功能紊乱 

分 类 号：R457.1[医药卫生—治疗学]