大量输血后患者相关生化指标的变化及临床意义  

Changes and clinical significance of related biochemical indexes in patients after massive transfusion

作　　者：朱娜[1] 王选杰 ZHU Na;WANG Xuan-jie(Hanzhong Second People's Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市第二人民医院

出　　处：《临床医学研究与实践》2019年第32期126-128,共3页Clinical Research and Practice

摘　　要：目的探讨大量输血后患者相关生化指标的变化及临床意义。方法选取我院收治的100例需要输血的患者为研究对象,按输血量分为对照组(50例)和试验组(50例),对照组的输血量少于2 000 mL,试验组的输血量多于2 000 mL。比较两组输血前、后的血小板数量、凝血功能指标、生化指标、血清电解质指标、血气指标水平以及低钾血症、低氧血症和代谢性酸中毒的发生率。结果输血后,试验组的血小板数量低于输血前;试验组的纤维蛋白原水平低于对照组和输血前,活化部分凝血活酶时间短于对照组和输血前,凝血酶时间和凝血酶原时间均长于对照组和输血前;试验组的直接胆红素、总胆红素、乳酸脱氢酶、谷丙转氨酶、谷草转氨酶水平均高于对照组和输血前;试验组的Na+、K+、和Cl-水平均高于对照组和输血前,Ca2+水平低于对照组和输血前;试验组的动脉血pH值、血乳酸水平均低于对照组和输血前,碱剩余水平高于对照组和输血前;试验组的低钾血症、低氧血症和代谢性酸中毒发生率均高于对照组,上述结果均差异显著(P<0.05)。结论大量输血后,患者机体内环境会发生变化,尤其是电解质、凝血功能指标以及血气指标水平,在给患者输血时,应多加留意,以减少输血并发症的发生。Objective To explore the changes and clinical significance of related biochemical indexes in patients after massive transfusion. Methods A total of 100 patients who needed blood transfusion admitted in our hospital were selected as the research objects. According to the amount of blood transfusion, the patients were divided into control group(50 cases) and experimental group(50 cases). The amount of blood transfusion in the control group was less than 2 000 mL,and amount of blood transfusion in the experimental group was more than 2 000 mL. The number of platelets, the levels of blood coagulation function index, biochemical index, serum electrolyte index, blood gas index and the incidence of hypokalemia, hypoxemia and metabolic acidosis before and after blood transfusion were compared between the two groups.Results After blood transfusion, the number of platelets in the experimental group was lower than that before blood transfusion;the fibrinogen level of the experimental group were lower than that of the control group and before blood transfusion, the activated partial thromboplastin time was shorter than that of the control group and before blood transfusion, the thrombin time and prothrombin time was longer than those of the control group and before blood transfusion;the levels of direct bilirubin, total bilirubin, lactic dehydrogenase, alanine aminotransferase and glutamic oxaloacetylase transferase in the experimental group were higher than those in the control group and before blood transfusion;the levels of Na+, K+, Cl- in the experimental group were higher than those in the control group and before blood transfusion, and the level of Ca2+ in the experimental group was lower than that in the control group and before blood transfusion;the pH value of arterial blood and the level of blood lactate in the experimental group were lower than those in the control group and before blood transfusion, and the level of alkali surplus was higher than that in the control group and before blood transfusion;the incidenc

关 键 词：大量输血 生化指标 凝血功能 血气指标 血清电解质指标 

分 类 号：R457.1[医药卫生—治疗学]