不同比例的成分血输注对急性创伤性凝血病患者预后的影响  

Effect of Different Proportion of Component Blood Infusion onPrognosis of Patients with Acute Traumatic Coagulation

作　　者：宛凯玲 WAN Kailing(Department of Blood Supply,Zhumadian Central Blood Station,Zhumadian Henan 463000,China)

机构地区：[1]驻马店市中心血站供血科,河南驻马店463000

出　　处：《临床研究》2024年第2期8-11,共4页Clinical Research

摘　　要：目的分析不同比例成分输血用于急性创伤性凝血病(ATC)患者对其预后的影响。方法回顾性分析2022年1月至2023年1月期间在本地区开展输血的ATC患者总共96例的病历资料,依据不同成分血输注比例分成对照组(依据3∶1比例输注悬浮红细胞以及新鲜冰冻血浆)50例和观察组(依据1∶1比例输注悬浮红细胞以及新鲜冰冻血)46例,观察两组血制品应用情况;输血前后血红蛋白(Hb)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分的凝血酶原时间(APTT)、国际标准化比值(INR)、纤维蛋白原(FIB)及D-二聚体(D-D)水平;血液钙离子(Ca^(2+))以及钾离子(K^(+))浓度;预后情况。结果两组24 h红细胞输注量、红细胞输注总量、血小板输注量以及冷沉淀输注量比较,差异无统计学意义(P>0.05);观察组的血浆输注量高于对照组,差异有统计学意义(P<0.05)。输血前,两组Hb、PLT水平比较,差异无统计学意义(P>0.05);输血后,两组Hb、PLT水平均有所升高,差异有统计学意义(P<0.05),但组间相比,差异无统计学意义(P>0.05)。输血前,两组PT、APTT、INR、FIB及D-D水平比较,差异无统计学意义(P>0.05);输血后,两组PT、APTT、INR、FIB及D-D水平均有所降低,且观察组低于对照组,差异有统计学意义(P<0.05)。输血前,两组Ca^(2+)、K^(+)浓度比较,差异无统计学意义(P>0.05);输血后,两组Ca^(2+)、K^(+)浓度均有所提高,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05)。观察组的治愈率高于对照组,差异有统计学意义(P<0.05);观察组未治愈率及死亡率低于对照组,差异有统计学意义(P<0.05)。结论和按照3∶1比例输注成分血相比,按照1∶1比例输注成分血能更好改善ATC患者的凝血功能,提升其预后水平,值得采用。Objective To analyze the effect of different proportion component transfusion on prognosis of patients with acute traumatic coagulation disease(ATC).Methods Retrospective analysis of the medical records of 96 ATC patients who underwent transfusion in the region between January 2022 and January 2023.According to the blood transfusion ratio of different components,50 cases were divided into control group(infusion of suspended red blood cells and fresh frozen plasma according to 3:1 ratio)and 46 cases were divided into observation group(infusion of suspended red blood cells and fresh frozen blood according to 1:1 ratio).The blood products usage conditions were observed.Patient’s treatment outcomes were appraised through the hemoglobin(Hb),blood platelet count(PLT),prothrombin time(PT),activated partial thromboplastin time(APTT),internal normalized ratio(INR),Fibrinogen(FIB)and D-dimer(D-D)levels;serum calcium ion(Ca^(2+))and potassium ion(K^(+))concentrations and clinical prognosis.Results There were no significant between-group differences about 24-hour red blood cell infusion volume,total red blood cell infusion volume,blood platelet infusion volume and cryoprecipitation infusion volume(P>0.05);the plasma transfusion volume in the observation group was larger than control group,the difference was statistically significant(P<0.05);before transfusion,Hb and PLT contents between groups were not significantly different(P>0.05);after transfusion,Hb and PLT contents for two groups were increased(P<0.05);but no significant differences were observed between groups(P>0.05);before transfusion,PT,APTT,INR,FIB and D-D values between groups were not significantly different(P>0.05);after transfusion,PT,APTT,INR,FIB and D-D values for two groups were reduced,PT,APTT and INR,FIB and D-D values in the observation group were even lower than control group,the difference was statistically significant(P<0.05);before transfusion,Ca^(2+)and K^(+)concentrations between groups were not significantly different(P>0.05);after transfusion,C

关 键 词：急性创伤性凝血病 红细胞 冰冻血浆 输血 预后 

分 类 号：R826.26[医药卫生—临床医学]