血液成分的输血比例对大量输血患者死亡率影响  

Study of influence of transfusion ratios of blood components on mortality of patients with massive transfusion

作　　者：辛峰[1] 高海燕[1] 孔燕[1] 马现君[1] 

机构地区：[1]山东大学齐鲁医院输血科,济南250012

出　　处：《临床血液学杂志（输血与检验）》2017年第5期815-819,共5页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：济南市高校院所自主创新项目(No:201102068)

摘　　要：输血是临床上常用的治疗手段之一,具有不可替代性,严重出血性患者由于失血量较大,病情较复杂,必需进行大量输血[1]。大量输血常用于急性大出血、严重创伤、大手术等情况,可迅速纠正失血过多和严重贫血,在失血性手术患者的救治中得到越来越广泛的应用[2],但短期大量输入库存血液常出现电解质紊乱,而且患者会存在血液的稀释、Massive transfusion is defined as the equal volume of transfusion to that of the loss of one within a 24 hours period or defined as receiving 10 or more units of red blood cells in 24 hours.However,this definition was full of controversy because of failing to eliminate survival bias.Other definitions have been put forward to improve it such as transfusion of the volume of 5 or more units of red blood cells in 4 hours or the rate of transfusion of 4 or more units of red blood cells per hour.Alternatively CAT,which was defined by receiving 3 or more units of red blood cells within any 1-hour time frame during the first 24 hours after injury,was raised to eliminate survival bias to some extent.Researchers have proposed the concept of Resuscitation Intensity,which was consisted of all fluids used for the initial resuscitation of a patient,not only red blood cells,plasma and platelets but also crystalloid,colloid,by carrying out the study of PROMMTT.As a result,the concept of Resuscitation Intensity is objective relatively to assess the severity of patients with massive loss of blood.The ratios of transfusion were concluded as 1：1 for plasma relative to red blood cells as well as 1：1：1 for plasma,platelets relative to red blood cells home mostly.And for abroad it was still inconclusive of how patients benefiting from high ratios of transfusion of plasma relative to red blood cells or high ratios of transfusion of plasma,platelets relative to red blood cells.Therefore further researches ought to be carried out to clarify the relationship between the ratios of transfusion and its influence in the mortality of patients with massive transfusion.

关 键 词：大量输血 输血比例 死亡率 

分 类 号：R457.1[医药卫生—治疗学]