不同成分输血比例对严重创伤患者凝血指标止血率及近期预后的影响  

Effects of Different Proportions of Blood Component Transfusion on Coagulation Parameters,Hemostasis Rate and Short-term Prognosis in Patients with Severe Trauma

作　　者：于桂芬 翁文浩 李汉华 周雄文 YU Guifen;WENG Wenhao;LI Hanhua(Yangpu Hospital Affiliated to Tongji University, Shanghai 200090, China)

机构地区：[1]同济大学附属杨浦医院

出　　处：《河北医学》2020年第3期518-522,共5页Hebei Medicine

基　　金：上海市科学技术委员会，(编号:18411969900)

摘　　要：目的:研究不同成分输血比例对严重创伤患者凝血功能、止血率及近期预后的影响。方法:回顾性分析我院2016年6月至2018年6月收治的严重创伤患者一般资料,根据血浆(FP):红细胞(RBC)输注比例,将其分为A(FP:RBC≤1:2,n=21)、B(1:2<FP:RBC<1:1,n=26)、C(FP:RBC≥1:1,n=20)三组,观察三组输血治疗前后凝血功能、血常规、止血率、存活率及血制品使用量。结果:较输血前比,三组患者输血后凝血酶原时间(PT)及活化部分凝血活酶时间(APTT)水平均显著延长,国际标准化比值(INR)水平显著上升,纤维蛋白原(FIB)含量显著下降(P<0.05),且三组输血后PT、INR、APTT及FIB水平差异显著(P<0.05);C组输血后血红蛋白(Hb)水平较输血前显著下降(P<0.05),A、B组输血前后Hb水平无显著性差异(P>0.05),三组输血后血小板计数(PLT)水平均较输血前显著下降(P<0.05),且三组输血后PLT水平差异显著(P<0.05);三组28d存活率无显著性差异(P>0.05);三组FP及冷沉淀使用量差异显著(P<0.05),RBC使用量无显著性差异(P>0.05)。结论:采用1:2<FP:RBC<1:1的比例进行成分输血能有效纠正重度创伤患者凝血功能障碍与血常规水平,改善患者预后,值得临床推广。Objective:To study the effects of different proportions of blood component transfusion on coagulation function,hemostasis rate and short-term prognosis in patients with severe trauma.Methods:The general data of patients with severe traumaadmitted to our hospital from June 2016 to June 2018 were retrospectively analyzed.According to the infusion proportion of plasma(FP)and red blood cell(RBC),they were divided into group A(FP:RBC≤1:2,n=21),group B(1:2<FP:RBC<1:1,n=26)and group C(FP:RBC≥1:1,n=20).The coagulation function,blood routine,hemostasis rate,survival rate and blood product usage were observed in the three groups before and after blood transfusion treatment.Results:The prothrombin time(PT)and activated partial thromboplastin time(APTT)in the three groups were significantly prolonged compared with those before blood transfusion,and the international normalized ratio(INR)level was increased significantly while the fibrinogen(FIB)level was significantly decreased(P<0.05),and there were significant differences in the PT,INR,APTT and FIB among the three groups after blood transfusion(P<0.05).The level of hemoglobin(Hb)in group C after blood transfusion was significantly lower than that before blood transfusion(P<0.05),and there was no significant difference in Hb level between group A and group B before and after blood transfusion(P>0.05),and the platelet count(PLT)level in the three groups after blood transfusion was significantly lower than that before blood transfusion(P<0.05),and there was a significant difference in the PLT levels among the three groups after blood transfusion(P<0.05).There was no significant difference in the 28d survival rate among the three groups(P>0.05).There were significant differences among the three groups in the FP and cryoprecipitate usage(P<0.05),and there was no significant difference in the RBC usage(P>0.05).Conclusion:Blood component transfusion with proportion of 1:2<FP:RBC<1:1 can effectively correct coagulation disorders and blood routine level and improve the prognosi

关 键 词：不同成分输血比例 严重创伤患者 凝血功能 止血率 近期预后 

分 类 号：R641[医药卫生—外科学]