大量输血对创伤患者电解质平衡及凝血功能的影响  

Influences of massive blood transfusion on electrolyte balance and coagulation function in patients with trauma

作　　者：王苗 雷芳 任艳利 张筱东[2] WANG Miao;LEI Fang;REN Yanli;ZHANG Xiaodong(Clinical Laboratory Department,Xi'an Fengcheng Hospital,Xi'an 710021;Clinical Laboratory Department,Yan'an People's Hospital,Yan'an 716000,China)

机构地区：[1]西安凤城医院检验科,陕西西安710021 [2]延安市人民医院检验科,陕西延安716000

出　　处：《临床医学研究与实践》2020年第33期67-69,共3页Clinical Research and Practice

摘　　要：目的分析大量输血对创伤患者电解质平衡及凝血功能的影响。方法将2018年1月至2019年12月我院收治的112例需输血的创伤患者按输血量分为对照组(少量输血治疗)和观察组(大量输血治疗),各56例。比较两组的治疗效果。结果治疗前、治疗5 d后,两组APTT、TT、PT、INR、D-D水平无显著差异(P>0.05);治疗1 d后,观察组APTT、TT、PT长于对照组,INR、D-D水平高于对照组(P<0.05)。治疗前、治疗5 d后,两组Na^+、K^+、Ca^2+、Cl^-水平无显著差异(P>0.05);治疗1 d后,观察组Na^+、K^+、Cl^-水平高于对照组,Ca^2+水平低于对照组(P<0.05)。治疗后,观察组APACHEⅡ、SOFA评分均低于对照组(P<0.05)。结论对创伤患者进行大量输血治疗可有效改善急性生理症状及预后情况,但短期内对凝血功能及电解质平衡的影响较大,治疗中需严密监测,选择适宜的输血量,防止出现凝血功能障碍及电解质紊乱。Objective To analyze the influences of massive blood transfusion on electrolyte balance and coagulation function in patients with trauma.Methods According to the volume of blood transfusion,112 trauma patients needing blood transfusion admitted in our hospital from January 2018 to December 2019 were divided into control group(treated with small amount of blood transfusion)and observation group(treated with massive blood transfusion),with 56 cases in each group.The therapeutic effects of the two groups were compared.Results There were no significant differences in APTT,TT,PT,INR and D-D between the two groups before and after 5 d of treatment(P>0.05);after 1 d of treatment,APTT,TT and PT in the observation group were longer than those in the control group,INR and D-D level were higher than those in the control group(P<0.05).There were no significant differences in Na^+,K^+,Ca^2+,Cl^- levels between the two groups before and after 5 d of treatment(P>0.05);after 1 d of treatment,the levels of Na^+,K^+ and Cl^- in the observation group were higher than those in the control group,and the level of Ca^2+ was lower than that in the control group(P<0.05).After treatment,APACHEⅡand SOFA scores in the observation group were lower than those in the control group(P<0.05).Conclusion In the treatment of trauma patients,massive blood transfusion can effectively improve the acute physiological symptoms and prognosis,but it has great impacts on blood coagulation function and electrolyte balance in a short period of time.Therefore,it is necessary to closely monitor and select the appropriate amount of blood transfusion to prevent coagulation dysfunction and electrolyte disorder.

关 键 词：创伤 大量输血 凝血功能 电解质 

分 类 号：R457.1[医药卫生—治疗学]