产后出血大量输血时不同血浆及红细胞比例输注的效果对比  

Comparison the Transfusion Effect of Different Plasma and Red Blood Cell Ratios during Massive Blood Transfusion in Postpartum Hemorrhage

作　　者：吴坤海[1] 陈陆飞[1] 黄慧芳[1] 钟文辉[1] 刘琛[1] WU Kunhai;CHEN Lufei;HUANG Huifang;ZHONG Wenhui;LIU Chen(Fujian Provincial Maternity and Children’s Hospital,Fuzhou 350001,China;不详)

机构地区：[1]福建省妇幼保健院,福建福州350001

出　　处：《中国医学创新》2021年第17期167-171,共5页Medical Innovation of China

摘　　要：目的:探讨产后出血大量输血时不同血浆及红细胞比例输注的效果。方法:选取2018年2月-2021年2月本院的228例产后出血需要大量输血的患者,依据不同的输注新鲜冰冻血浆(FFP)和悬浮红细胞(RBC)比例将228例患者分为三组,每组76例。研究1组输注比例为2.5︰1;研究2组输注比例为1︰1;研究3组输注比例为1︰1.5。比较三组输注血制品情况和住院情况及输血前后血常规、电解质、凝血功能。结果:三组24 h悬浮红细胞、血小板、冷沉淀输注量比较,差异均无统计学意义(P>0.05),总红细胞输注量、住院时长比较,差异均有统计学意义(P<0.05)。研究2组总红细胞输注量、住院时长均低于研究1、3组(P<0.05)。输血前,三组PLT、Hb、Na^(+)、Ca^(2+)、K^(+)、Fg、APTT、PT-INR、PT水平比较,差异均无统计学意义(P>0.05);第1次大量输血后1 d,研究2组的PLT、Hb水平均高于研究1、3组,差异均有统计学意义(P<0.05)。全部输血完成后,研究2组的K^(+)、Fg水平均高于研究1、3组,Na^(+)、Ca^(2+)、APTT、PT-INR、PT水平均低于研究1、3组,差异均有统计学意义(P<0.05)。结论:针对产后出血患者大量输血时RBC和FFP比例为1︰1时效果更佳,可以有效维持机体的电解质平衡,改善患者的凝血功能和血常规相关指标,同时可以降低总红细胞的输注量,缩短患者的住院时长,有利于患者的康复。Objective:To explore the transfusion effect of different plasma and red blood cell ratios during massive blood transfusion in postpartum hemorrhage.Method:A total of 228 patients with postpartum hemorrhage required massive blood transfusion in our hospital from February 2018 to February 2021 were selected,and divided into three groups according to different ratios of fresh frozen plasma(FFP)and suspended red blood cell(RBC),76 cases in each group.The infusion ratio of study group 1 was 2.5︰1;the infusion ratio of study group 2 was 1︰1;the infusion ratio of the study group 3 was 1︰1.5.Blood transfusion and hospitalization were compared of three groups,and blood routine,electrolyte and coagulation function before and after blood transfusion were compared of three groups.Result:There were no statistically significant differences in the infusion volume of 24 h suspended red blood cells,platelets and cryoprecipitate among the three groups(P>0.05),while there were statistically significant differences in the infusion volume of total red blood cells and length of hospitalization of three groups(P<0.05).The total red blood cell infusion volume and length of hospitalization of study group 2 were lower than those of study group 1,3(P<0.05).Before blood transfusion,there were no significant differences in the levels of PLT,Hb,Na^(+),Ca^(2+),K^(+),Fg,APTT,PT-INR and PT of three groups(P>0.05).1 d after the first massive transfusion,PLT and Hb levels of study group 2 were higher than those of study group 1,3,the differences were statistically significant(P<0.05).After all blood transfusions were completed,K+and Fg levels of study group 2 were higher than those of study group 1,3,while Na^(+),Ca^(2+),APTT,PT-INR and PT levels were lower than those of study group 1,3,the differences were statistically significant(P<0.05).Conclusion:For patients with postpartum hemorrhage,when the ratio of RBC to FFP is 1∶1,the effect is better,it can effectively maintain the body’s electrolyte balance,improve the patient’s coagulati

关 键 词：产后出血 大量输血 不同血浆及红细胞比例 

分 类 号：R457.1[医药卫生—治疗学] R714.461[医药卫生—临床医学]