成分输血联合限制性液体复苏在宫外孕破裂大出血休克中的应用  

Application of component blood transfusion combined with limited fluid resuscitation in hemorrhagic shock caused by rupture of ectopic pregnancy

作　　者：张凡[1] 辛德梅[1] ZHANG Fan;XIN Demei(Department of Obstetrics and Gynecology,Beijing Chuiyangliu Hospital,Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院妇产科,北京100022

出　　处：《中国妇幼健康研究》2022年第6期117-121,共5页Chinese Journal of Woman and Child Health Research

基　　金：北京市自然科学基金资助项目(D171100002817036)。

摘　　要：目的研究成分输血联合限制性液体复苏在宫外孕破裂大出血休克中的应用价值。方法选取2017年2月至2020年2月于北京市垂杨柳医院就诊的78例宫外孕破裂大出血休克患者为研究对象,随机分为对照组及观察组各39例。对照组采用限制性液体复苏,观察组在对照组基础上加用成分输血。比较两组治疗期间输液量、总输血量及住院时间,比较治疗前、治疗后2h两组血常规[血小板(PLT)、血红蛋白(Hb)、血气剩余碱(BE)、红细胞比容(HCT)]及凝血功能[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维原蛋白(FIB)],统计并发症发生率。结果观察组输液量、总输血量低于对照组,住院时间短于对照组,差异均有统计学意义(t值分别为13.402、23.964、6.362,P<0.05);治疗前两组血常规比较,差异无统计学意义(P>0.05);治疗后2h两组PLT、Hb、BE、HCT水平均高于治疗前,且观察组高于对照组(t值分别为10.420、5.903、9.595、2.336,P<0.05);治疗前两组凝血功能指标比较,差异无统计学意义(P>0.05);治疗后2h两组PT、APTT、TT小于治疗前,FIB大于治疗前,且观察组PT、APTT、TT小于对照组,FIB大于对照组(t值分别为9.413、7.210、5.852、6.395,P<0.05);治疗后3d内,观察组并发症发生率低于对照组,差异有统计学意义(χ^(2)=4.129,P<0.05)。结论成分输血联合限制性液体复苏应用于宫外孕破裂大出血休克能降低患者输液量、总输血量,缩短住院时间,改善血常规及凝血功能指标,并降低并发症发生率。Objective To study the application value of component blood transfusion combined with limited fluid resuscitation in hemorrhagic shock of ectopic pregnancy.Methods From February 2017 to February 2020,78 patients with hemorrhagic shock caused by rupture of ectopic pregnancy received in Beijing Chuiyangliu Hospital were enrolled and randomly divided into control group(39 cases)and observation group(39 cases).The control group was treated with restrictive fluid resuscitation,and the observation group was treated with component blood transfusion combined with restrictive fluid resuscitation.The infusion volume,total blood transfusion and hospital stay during treatment were compared between the two groups,and the blood routines[platelet(PLT),hemoglobin(Hb),base excess(BE),hematocrit(HCT)]and coagulation function[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)]were compared before treatment and 2 h after treatment,the incidence of complications was counted.Results The infusion volume,total blood transfusion in the observation group were lower than those in the control group,and the hospital stay was shorter than that in the control group,the differences were statistically significant(t=13.402,23.964 and 6.362,respectively,P<0.05).Before treatment,there was no significant difference in blood routine between the two groups(P>0.05).2 hours after treatment,the levels of PLT,Hb,BE and HCT in both groups were higher than before,and the observation group were higher than the control group(t=10.420,5.903,9.595 and 2.336,respectively,P<0.05).There was no significant difference in coagulation function indexes between the two groups before treatment(P>0.05).2 hours after treatment,PT,APTT and TT in two groups were smaller than before treatment,while FIB was larger than before treatment.PT,APTT and TT in observation group were smaller than control group,and FIB was larger than control group(t=9.413,7.210,5.852 and 6.395,respectively,P<0.05).Within 3 days after treatment,the co

关 键 词：宫外孕破裂 大出血休克 成分输血 限制性液体复苏 

分 类 号：R173[医药卫生—妇幼卫生保健]