新鲜冰冻血浆和冷沉淀联合输注对上消化道大出血患者凝血和免疫功能的影响  

Effects of Fresh Frozen Plasma Combined with Cryoprecipitation on Coagulation and Immune Function in Patients with Upper Gastrointestinal Hemorrhage

作　　者：黎永华 陈嫦 李光宇 庞福梅 彭锡其 LI Yonghua;CHEN Chang;LI Guangyu;PANG Fumei;PENG Xiqi(People’s Hospital of Luoding,Luoding 527200,China;不详)

机构地区：[1]广东省罗定市人民医院,广东罗定527200 [2]广东省罗定市分界镇卫生院 [3]广东省罗定市黎少镇中心卫生院

出　　处：《中国医学创新》2020年第7期52-55,共4页Medical Innovation of China

摘　　要：目的:探讨新鲜冰冻血浆和冷沉淀联合输注对上消化道大出血患者凝血功能和免疫功能的影响。方法:选取2016年3月-2019年3月罗定市人民医院92例上消化道大出血患者为研究对象,按随机数字表法分为对照组和研究组,每组46例。对照组输注同型新鲜冰冻血浆,研究组在对照组基础上联合冷沉淀足量输注。比较两组治疗前后凝血功能和免疫功能,比较两组治疗效果。结果:治疗前,两组纤维蛋白原(FIB)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)及凝血酶原时间(PT)比较,差异均无统计学意义(P>0.05);治疗后,研究组FIB高于对照组,而TT、APTT和PT均低于对照组(P<0.05)。治疗前,两组CD8+、CD4+、CD3+及CD4+/CD8+比较,差异均无统计学意义(P>0.05);治疗后,研究组CD8+低于对照组,而CD4+、CD3+及CD4+/CD8+均高于对照组(P<0.05);研究组治疗总有效率(97.83%)高于对照组(82.61%),差异有统计学意义(P<0.05)。结论:新鲜冰冻血浆与冷沉淀联合输注可有效改善消化道大出血患者凝血功能障碍和输血所致的细胞免疫抑制,提高临床治疗效果。Objective:To investigate the effect of combined infusion of fresh frozen plasma and cryoprecipitation on coagulation and immune function in patients with upper gastrointestinal hemorrhage.Method:A total of 92 patients with upper gastrointestinal hemorrhage in people’s hospital of Luoding from March 2016 to March 2019 were selected as the study objects.They were divided into control group and research group according to the random number table method,with 46 cases in each group.The control group was infused with fresh frozen plasma of the same blood group,and the research group was adequate infusion of cryoprecipitation on the basis of the control group.The coagulation function and immune function were compared,and the therapeutic efficiency of the two groups was compared.Result:There were no differences in fibrinogen(FIB),thrombin time(TT),activated partial thromboplastin time(APTT)and prothrombin time(PT)between the two groups before treatment(P>0.05).After treatment,FIB in the research group was higher than that in the control group,while TT,APTT and PT were lower than those in the control group(P<0.05).There were no differences in CD8+,CD4+,CD3+and CD4+/CD8+between the two groups before treatment(P>0.05).After treatment,CD8+in the research group was lower than that in the control group,while CD4+,CD3+and CD4+/CD8+in the research group were higher than those in control group(P<0.05).The total effective rate(97.83%)in the research group was higher than that in the control group(82.61%),and the difference was statistically significant(P<0.05).Conclusion:Fresh frozen plasma combined with cryoprecipitation can effectively improve coagulation dysfunction and cellular immune suppression caused by blood transfusion in patients with gastrointestinal hemorrhage,and improve clinical therapeutic effect.

关 键 词：新鲜冰冻血浆 冷沉淀 消化道大出血 凝血功能 免疫功能 

分 类 号：R573.2[医药卫生—消化系统] R457.1[医药卫生—内科学]