为创伤性大出血患者使用不同比例的血浆和浓缩红细胞进行输血的效果探讨  

To study the effect of blood transfusion with different proportion of plasma and concentrated red blood cells in patients with traumatic hemorrhage

作　　者：刘念[1] Liu Nian(Department of blood transfusion,rongxian people＇s hospital,Rongxian Sichuan 643100)

机构地区：[1]荣县人民医院输血科,四川荣县643100

出　　处：《当代医药论丛》2018年第19期34-36,共3页

摘　　要：目的 :探讨为创伤性大出血患者使用不同比例的血浆和浓缩红细胞进行输血的效果。方法 :将2013年1月至2017年12月期间荣县人民医院输血科收治的84例创伤性大出血患者作为研究对象。根据输注血浆和浓缩红细胞比例的不同,将这84例患者分为低比例组、中比例组及高比例组三组。其中,低比例组有28例患者,中比例组有29例患者,高比例组有27例患者。为低比例组患者输注的血浆和浓缩红细胞的比例为1:5,为中比例组患者输注的血浆和浓缩红细胞的比例为1:2.5,为高比例组患者输注的血浆和浓缩红细胞的比例为1:1。然后,对比三组患者在输血前、输血后12 h及输血后24 h的各项凝血功能指标,并对比其死亡率及死亡患者的生存时间。结果:1)三组患者输血前及输血后12 h,其PT(凝血酶原时间)、APPT(活化部分凝血活酶时间)及其血浆Fb(纤维蛋白原)的水平相对比,差异无统计学意义(P>0.05)。2)与输血前相比,输血后12 h和输血后24 h,三组患者的PT、APPT均延长,其血浆Fb的水平降低(P <0.01)。3)输血后24 h,与中比例组患者及低比例组患者相比,高比例组患者的PT、APPT更长,其血浆Fb的水平更低(P <0.01);与低比例组患者相比,中比例组患者的PT、APPT更长,其血浆Fb的水平更低(P <0.01)。4)输血后,三组患者的死亡率相对比,差异无统计学意义(P>0.05)。5)输血后,与中比例组和低比例组相比,高比例组中死亡患者的平均生存时间更长(P <0.01)。结论 :对创伤性大出血患者进行不同比例输血的效果不同,当为其输注的血浆和浓缩红细胞的比例为1:1时,治疗效果最好。Objective： To investigate the effect of blood transfusion with different proportion of plasma and concentrated red blood cells for patients with traumatic hemorrhage. Methods： 84 patients with traumatic hemorrhage admitted to the blood transfusion department of rongxian people＇s hospital from January 2013 to December 2017 were studied. The 84 patients were divided into three groups： low proportion group, medium proportion group and high proportion group. Among them, there were 28 patients in the low proportion group, 29 patients in the medium proportion group and 27 patients in the high proportion group. The proportion of plasma and concentrated red blood cells was 1：5 in the low proportion group, 1：2.5 in the medium proportion group and 1：1 in the high proportion group. Then, the blood coagulation function indexes of the three groups were compared before and after transfusion for 12 h and 24 h after transfusion, and the mortality rate and the survival time of the dead patients were compared. Results： 1） the relative levels of PT（prothrombin time）, APPT（activation time of partial prothrombin） and plasma Fb（fibrinogen） of patients in the three groups before and 12 h after blood transfusion showed no significant difference（P〉0.05）. 2） compared with before transfusion, the PT and APPT of patients in the three groups were prolonged at 12 h after transfusion and 24 h after transfusion, and the plasma Fb level was reduced（P〈0.01）. 3） 24 h after blood transfusion, patients in the high proportion group had longer PT and APPT and lower plasma Fb level than patients in the medium proportion group and the low proportion group（P〈0.01）. Compared with patients in the low proportion group, patients in the medium proportion group had longer PT and APPT and lower plasma Fb（P〈0.01）. 4） after blood transfusion, the relative mortality ratio of the three groups showed no significant difference（P〈0.05）. 5） after blood transfusion, the average survival time of the pati

关 键 词：创伤性大出血 输血 血浆 浓缩红细胞 

分 类 号：R641[医药卫生—外科学]