去白细胞悬浮红细胞及冷沉淀凝血因子联合输注对产后大出血患者的应用效果  

Effect of Combined Infusion of Leukocyte-Depleted Red Blood Cells and Cryoprecipitated Coagulation Factors on Patients with Postpartum Hemorrhage

作　　者：张红军 张楠 陶松涛 ZHANG Hongjun;ZHANG Nan;TAO Songtao(Department of blood transfusion,General Hospital of Pingmei Shenma Group,Pingdingshan 467000,China)

机构地区：[1]平煤神马医疗集团总医院输血科,河南平顶山467000

出　　处：《河南医学研究》2021年第24期4489-4491,共3页Henan Medical Research

摘　　要：目的分析去白细胞悬浮红细胞及冷沉淀凝血因子联合输注应用于产后大出血患者的效果。方法选取2018年4月至2021年2月平煤神马医疗集团总医院收治的81例产后大出血患者作为研究对象,根据输注方案分为观察组(n=45)与对照组(n=36),对照组常规输注去白细胞悬浮红细胞,观察组在对照组基础上联合输注冷沉淀凝血因子,比较两组输注前及输注后4 h凝血功能,包括活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT),比较两组平均止血时间、止血有效率、免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))。结果输注后4 h,两组APTT、PT、TT时间变短,FIB水平升高,差异有统计学意义(P<0.05)。输注后4 h,观察组APTT、PT、TT短于对照组,FIB水平高于对照组,差异有统计学意义(P<0.05)。观察组平均止血时间短于对照组,24 h后有效止血率高于对照组,差异有统计学意义(P<0.05)。输注后4 h,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均降低,但观察组高于对照组,差异有统计学意义(P<0.05)。结论去白细胞悬浮红细胞及冷沉淀凝血因子联合输注应用于产后大出血患者,可促进凝血功能改善,缩短止血时间,提高止血效果,降低血液输注造成的免疫抑制反应,值得临床推广应用。Objective To analyze the value of combined infusion of leukocyte-removed,suspended red blood cells and cryoprecipitated coagulation factors in patients with postpartum hemorrhage.Methods The clinical datas of 81 patients with postpartum hemorrhage in General Hospital of Pingmei Shenma Group from April 2018 to February 2021 were collected and retrospectively studied.According to different infusion schemes,they were divided into observation group(n=45)and control group(n=36).The control group was routinely infused with leukocyte-removed and suspended red blood cells,and the observation group was combined with cryoprecipitate coagulation factors on the basis of the control group.The coagulation function of the two groups before and after the infusion was compared[activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),thrombin time(TT)],average hemostasis time,effective rate of hemostasis,immune function(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)).Results The APTT,PT,TT in the 2 groups were shorter than before the infusion at 4 h after the infusion,and the FIB level was higher than before the infusion(P<0.05).The APTT,PT,TT in the observation group were shorter than the control group at 4 h after the infusion,and the FIB level was higher than that of the control group(P<0.05).The average hemostasis time of the observation group was shorter than that of the control group,and the effective hemostasis rate after 24 h was higher than that of the control group(P<0.05).Four hours after infusion,the CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were lower than before infusion,but the observation group was higher than the control group(P<0.05).Conclusion The combined infusion of leukocyte-removed suspended red blood cells and cryoprecipitated coagulation factors in patients with postpartum hemorrhage can improve the coagulation function,shorten the hemostasis time,improve the hemostasis effect,and reduce the immunosuppressive reaction caused by blood infusion.It is worthy of clinical application.

关 键 词：产后大出血 去白细胞悬浮红细胞 冷沉淀凝血因子 凝血功能 

分 类 号：R457.1[医药卫生—治疗学]