不同比例血浆与红细胞输注对创伤性失血患者大量输血救治的影响  

Influence of different ratios of plasma and red blood cell transfusion on the treatment of massive blood transfusion in patients with traumatic hemorrhage

作　　者：平旭东 PING Xu-dong(Department of Blood Transfusion,Huludao Sixth People’s Hospital,Huludao 125022,China)

机构地区：[1]辽宁省葫芦岛市第六人民医院输血科,125022

出　　处：《中国实用医药》2022年第10期159-161,共3页China Practical Medicine

摘　　要：目的 探讨创伤性失血患者输注大量不同比例血浆与红细胞救治的临床疗效。方法 231例创伤性大量失血患者,根据患者入院24 h内输注血浆与悬浮红细胞的比例分为1组、2组及3组,每组77例。1组输注血浆与悬浮红细胞比例为2.5∶1,2组输注血浆与悬浮红细胞比例为1∶1,3组输注血浆与悬浮红细胞比例为1∶1.5。比较三组输血前后血小板计数(PLT)及血红蛋白(Hb),入院24 h输注血制品情况(输注悬浮红细胞、血小板、冷沉淀及红细胞输注总量),输血前后凝血指标[活化部分凝血活酶时间(APTT)、凝血酶原国际标准化比值(PT-INR)及血浆纤维蛋白原(Fg)]。结果 输血前,三组PLT、Hb水平比较,差异无统计学意义(P>0.05);输血后24 h,2组PLT、Hb水平均明显高于1组和3组,差异具有统计学意义(P<0.05)。三组入院24 h输注悬浮红细胞、血小板、冷沉淀比较,差异无统计学意义(P>0.05);2组入院24 h红细胞输注总量(17.98±5.46)U显著少于1组的(24.02±7.12)U和3组的(22.16±6.24)U,差异具有统计学意义(P<0.05)。输血前,三组APTT、PT-INR及Fg比较,差异无统计学意义(P>0.05);输血后,2组APTT短于1组和3组,PT-INR和低于1组和3组,Fg高于1组和3组,差异有统计学意义(P<0.05)。结论 对创伤性大量失血患者输注比例1∶1血浆与悬浮红细胞可有效预防大量失血后凝血功能障碍,降低患者治疗期间的红细胞输注总量,节约血液资源。Objective To discuss the clinical efficacy of different ratios of plasma and red blood cell transfusion on the treatment of massive blood transfusion in patients with traumatic hemorrhage.Methods A total of 231 patients with traumatic massive hemorrhage were divided into group 1,group 2 and group 3 according to the ratio of transfused plasma to suspended red blood cells within 24 h of admission,with 77 cases in each group.The ratio of transfused plasma to suspended red blood cells was 2.5∶1 in group 1,1∶1 in group 2,and 1∶1.5 in group 3.The platelet count(PLT) and hemoglobin(Hb) before and after transfusion,transfusion of blood products(transfusion of suspended red blood cells,platelets,cryoprecipitate and total red blood cell transfusion) at 24 h of admission,coagulation indexes[activated partial thromboplastin time(APTT),prothrombin international normalized ratio(PT-INR) and plasma fibrinogen(Fg)] before and after transfusion were compared among the three groups.Before blood transfusion,there was no statistically significant difference in the levels of PLT and Hb among the three groups(P>0.05).At 24 h after blood transfusion,the levels of PLT and Hb in group 2 were significantly higher than those in group 1 and 3,and the difference was statistically significant(P<0.05).There was no statistically significant difference among the three groups in the 24 h transfusion of suspended red blood cells,platelets and cryoprecipitate(P>0.05).The total amount of red blood cell transfusion(17.98±5.46) U in group 2 was significantly less than(24.02±7.12) U in group 1 and(22.16±6.24) U in group 3,and the difference was statistically significant(P<0.05).Before transfusion,there was no statistically significant difference in APTT,PT-INR and Fg among the three groups(P>0.05).After blood transfusion,the APTT in group 2 was shorter than that in group 1 and group 3,the PT-INR was lower than that in group 1 and group 3,and the FG was higher than that in group 1 and group 3.All the differences were statistically significant(P

关 键 词：血浆 红细胞 创伤性大量失血 大量输血 

分 类 号：R605.971[医药卫生—急诊医学] R457.1[医药卫生—外科学]