血浆及时输注对大量输血患者凝血指标变化的影响  

Effect of Timely Plasma Infusion on Changes of Blood Coagulation Index in Patients with Mass Blood Transfusion

作　　者：余红亚 周红梅 郑兴平 黄姝婷 YU Hong-ya;ZHOU Hong-mei;ZHENG Xing-ping(Department of Blood Transfusion,Bozhou District People’s Hospital,Zunyi,Guizhou,563100,China)

机构地区：[1]遵义市播州区人民医院输血科,贵州遵义563100

出　　处：《黑龙江医学》2022年第16期1984-1986,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨血浆及时输注对大量输血患者凝血指标水平的影响。方法:选择2018年1月—2020年10月遵义市播州区人民医院收治的212例输血患者作为研究对象,按随机数表法将患者分为对照组和观察组,每组各106例。对照组仅输注悬浮红细胞,观察组输注悬浮红细胞与血浆,对比两组凝血功能[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、血液流变学[血小板计数(PLT)、血红蛋白(Hb)、血细胞比容(HCT)]、不良反应、住院时间及凝血功能障碍发生率。结果:观察组输血后1 d PT、APTT、TT均短于对照组,FIB水平高于对照组,差异有统计学意义(t=5.675、3.188、3.818、1.135,P<0.05);观察组输血后1 d血液流变学指标水平均高于对照组,差异有统计学意义(t=3.951、4.759、6.465,P<0.05);两组患者不良反应发生率相比,差异无统计学意义(χ^(2)=2.434,P>0.05);对照组住院时间长于观察组,差异无统计学意义(t=0.949,P=0.344>0.05);两组患者凝血功能障碍发生率相比,差异无统计学意义(χ^(2)=2.753,P=0.097>0.05)。结论:大出血患者接受大量输血后,其凝血功能会发生变化,因此输血过程中应注意监测患者凝血功能与血液流变学指标水平,及时给予适当的血浆输注,以改善机体凝血功能,保证血液输注效果,减少不良情况的发生,缩短住院时间。Objective: To investigate the effect of timely plasma transfusion on coagulation index levels in patients with massive blood transfusion. Methods: A total of 212 blood transfusion patients admitted to the hospital from January 2018 to October2020 were selected as the research subjects, and the patients were divided into two groups according to the random number table method, with 106 cases in each group. The control group were only infused with suspended red blood cells, while the observation group were infused with suspended red blood cells and plasma. The coagulation function(prothrombin time [PT], activated partial prothrombin time [APTT], thrombin time [TT], fibrinogen [FIB]), blood rheology(platelet count [PLT], Hemoglobin [Hb], hematocrit[HCT]), adverse reactions, length of hospital stay, and incidence of coagulation disorders were compared between the two groups.Results: The PT, APTT and TT of the observation group at 1 d after blood transfusion were shorter than those of the control group,and the level of FIB was higher than that of the control group, and the difference was statistically significant(t=5.675, 3.188,3.818, 1.135, P<0.05). The levels of hemorheological indexes in the observation group were higher than those in the control group on the 1st day after blood transfusion, and the difference was statistically significant(t=3.951, 4.759, 6.465, P<0.05). The incidence of adverse reactions in the two groups was similar, and the difference was not statistically significant(χ^(2)=2.434, P>0.05).The hospital stay in the control group was longer than that in the observation group, and the difference was not statistically significant(t=0.949, P=0.344>0.05). There was no statistically significant difference in the incidence of coagulation dysfunction between the two groups(χ^(2)=2.753, P=0.097>0.05). Conclusion: After massive blood transfusions, the blood coagulation function of patients with major bleeding changes. Therefore, during the blood transfusion process, attention should be paid to monitoring t

关 键 词：大出血 大量输血 血浆 凝血酶原时间 活化部分凝血酶原时间 凝血酶时间 纤维蛋白原 

分 类 号：R544[医药卫生—心血管疾病]