不同输血策略对外科创伤大出血患者凝血功能及血液资源消耗的影响  

Effects of Different Transfusion Strategies on Coagulation Function and Blood Resource Consumption in Patients with Traumatic Massive Hemorrhage

作　　者：孟照黄 Meng Zhao-huang(Department of Blood Transfusion,the First People's Hospital of Nanyang,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市第一人民医院输血科,河南南阳473000

出　　处：《罕少疾病杂志》2023年第10期95-96,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的探究不同输血策略对外科创伤大出血患者凝血功能及血液资源消耗的影响。方法收集本院2020年6月~2022年6月就诊的104例外科创伤大出血患者的临床资料,按不同输血策略划为30例A组[新鲜冰冻血浆(FFP):悬浮红细胞(RBCS)>1:1]、38例B组(FFP:RBCS>1:2~1:1)、36例C组(FFP:RBCS≤1:2)。比较三组凝血功能、血液资源消耗情况、ICU停留时间、住院时间及生存情况。结果三组输血后纤维蛋白原(FIB)均比输血前低,且C组比A组及B组低,B组比A组低(P<0.05);C组输血后活化部分凝血活酶时间(APTT)及凝血酶原时间(PT)均比A组及B组高(P<0.05);C组FFP用量比A组及B组低,且B组比A组低(P<0.05);三组RBCS用量、ICU停留时间、住院时间相比无差异(P>0.05);三组入院1d及1个月存活率相比无差异(P>0.05)。结论FFP:RBCS>1:2~1:1的输血策略可在不影响外科创伤大出血患者疗效的前提下改善其凝血功能,减少血液资源消耗。Objective to investigate the effects of different blood transfusion strategies on coagulation function and blood resource consumption in patients with traumatic massive hemorrhage.Methods the clinical data of 104 patients with traumatic massive hemorrhage from June 2020 to June 2022 were collected,according to different transfusion strategies,30 patients were divided into Group A(fresh frozen plasma(FFP-RRB-:suspended red blood cells(RBCS)>1:1),38 patientsGrouprBupFFP(FFP:RBCS>1:2~1:1)and 36 patientsGrouprCupFFP(FFP:RBCS≤1:2).The coagulation function,blood resource consumption,ICU stay time,hospital stay and survival were compared among the three groups.Results the fibrinogen(FIB)of three groups after blood transfusion was lower than that before blood transfusion,and Group C was lower than that of Group A and Group B,and Group B was lower than that of group a(P<0.05)The activated partial thromboplastin time(Aptt)and prothrombin time(PT)in Group C were higher than those in Group A and group B(P<0.05),the dosage of FFP in Group C was lower than those in Group A and Group B,and the dosage of FFP in Group B was lower than that in group a(P<0.05)The dose of RBCS,the length of stay in ICU and the length of stay in hospital had no difference among the three groups(P>0.05),and the 1-day and 1-month survival rates among the three groups had no difference(P>0.05).Conclusion the blood transfusion strategy of FFP:RBCS>1:2~1:1 can improve the blood coagulation function and reduce the blood resource consumption without affecting the curative effect of the patients with traumatic massive hemorrhage.

关 键 词：创伤大出血 外科 悬浮红细胞 凝血功能 新鲜冰冻血浆 

分 类 号：R457.1[医药卫生—治疗学]