血红蛋白<60 g/L时去白细胞悬浮红细胞输注在重型颅脑损伤患者的效果观察  

Observation on the Effect of De-leucocyte Suspension Red Blood Cell Infusion in Patients with Severe Craniocerebral Injury when Hemoglobin<60 g/L

作　　者：康素花 王冰斌 KANG Suhua;WANG Bingbin(Department of Clinical Laboratory,Xiamen City Huli District Jiangtou Street Community Health Centre,Xiamen 361000,China;Department of Clinical Laboratory,the First Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门市湖里区江头街道社区卫生服务中心检验科,福建厦门361000 [2]厦门大学附属第一医院检验科,福建厦门361000

出　　处：《中国医药指南》2023年第10期107-109,共3页Guide of China Medicine

摘　　要：目的分析血红蛋白(Hb)<60 g/L时去白细胞悬浮红细胞输注对重型颅脑损伤患者凝血功能的影响。方法选取我院2020年12月至2022年11月重型颅脑损伤患者75例,均进行去白细胞悬浮红细胞输注治疗,根据输注阈值不同分为观察组(n=38)、对照组(n=37),对照组在Hb为60~100 g/L时进行输注,观察组在Hb<60 g/L时输注,比较两组输注前后血常规指标[血小板(PLT)、红细胞压积(HCT)、红细胞计数(RBC)]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、输血量、不良事件发生率。结果输注后两组PLT、HCT、RBC水平均高于输注前(P<0.05);输注后观察组PLT、HCT、RBC水平均高于对照组(P<0.05);输注后两组APTT、PT、TT、FIB均低于输注前(P<0.05);输注后观察组APTT、PT、TT、FIB低于对照组(P<0.05);观察组输血量较对照组少(P<0.05);观察组不良事件发生率[7.89%(3/38)]较对照组[27.03%(10/37)]低(P<0.05)。结论血红蛋白<60 g/L时,将去白细胞悬浮红细胞输注用于重型颅脑损伤患者,可明显提高血液输注效果,减少输血量,预防或减轻凝血功能障碍,且不良事件发生率较低,值得临床推广应用。Objective To analyze the effect of de-leucocyte suspension red blood cell infusion on blood coagulation in patients with severe head injury when hemoglobin(Hb)<60 g/L.Methods Seventy-five patients with severe craniocerebral injury in our hospital from December 2020 to November 2022 were selected,and all were treated with de-leucocyte suspension red blood cell infusion.According to the infusion threshold,they were divided into the observation group(n=38)and the control group(n=37).The control group was infused when Hb was 60~100 g/L,and the observation group was infused when Hb was<60 g/L,and the blood routine indexes[platelet(PLT),hematocrit(HCT),erythrocyte count(RBC)]before and after infusion were compared coagulation function index[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)],blood transfusion volume,and incidence of adverse events.Results The levels of PLT,HCT and RBC in the two groups after infusion were higher than those before infusion(P<0.05);after infusion,the average water content of PLT,HCT and RBC in the observation group was higher than that in the control group(P<0.05);APTT,PT,TT and FIB in the two groups after infusion were lower than those before infusion(P<0.05);after infusion,APTT,PT,TT,FIB in the observation group were lower than those in the control group(P<0.05);the amount of blood transfusion in the observation group was less than that in the control group(P<0.05);the incidence of adverse events in the observation group was 7.89%(3/38)lower than that in the control group(27.03%,10/37)(P<0.05).Conclusion When hemoglobin is less than 60 g/L,the application of de-leucocyte suspension red blood cell infusion in patients with severe craniocerebral injury can significantly improve the effect of blood transfusion,reduce the volume of blood transfusion,prevent or reduce coagulation dysfunction,and the incidence of adverse events is low,which is worthy of clinical application.

关 键 词：重型颅脑损伤 血液输注 输注阈值 凝血功能 输血量 不良事件 

分 类 号：R651.15[医药卫生—外科学]