大量输血后患者相关生化指标的变化及临床价值  

Changes and clinical value of biochemical indicators related to patients after massive blood transfusion

作　　者：林丽屏[1] 陈登云 庄燕玲[1] LIN Li-ping;CHEN Deng-yun;ZHUANG Yan-ling(Blood Transfusion Department,Quanzhou First Hospital,Quanzhou 362000,China)

机构地区：[1]福建省泉州市第一医院输血科,362000

出　　处：《中国现代药物应用》2024年第3期16-20,共5页Chinese Journal of Modern Drug Application

摘　　要：目的讨论大量输血对患者各项生化指标的影响。方法选择需接受输血治疗的患者100例,根据输血量不同分为对照组(输血量≤2000 ml)与观察组(输血量>2000 ml),各50例。观察患者输血前后凝血功能指标[血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、血气分析指标(动脉血pH、血乳酸、碱剩余)、血清电解质水平[钠离子(Na^(+))、钾离子(K^(+))、氯离子(Cl^(-))、钙离子(Ca^(2+))]、生化指标[直接胆红素(DBil)、总胆红素(TBil)、乳酸脱氢酶(LDH)、丙谷转氨酶(ALT)、谷草转氨酶(AST)]水平。结果观察组输血后PT、APTT、TT、FIB分别为(24.12±6.63)s、(24.94±6.81)s、(27.01±5.42)s、(1.63±0.61)g/L,对照组输血后PT、APTT、TT、FIB分别为(16.80±3.31)s、(37.41±13.89)s、(17.11±2.01)s、(2.76±1.38)g/L;观察组患者输血后PT、TT长于本组输血前及对照组输血后,APTT短于本组输血前及对照组输血后,FIB低于本组输血前及对照组输血后,存在明显差异(P<0.05)。观察组输血后动脉血pH、血乳酸低于本组输血前及对照组输血后,碱剩余高于本组输血前及对照组输血后,存在明显差异(P<0.05)。观察组输血后Na^(+)、K^(+)、Cl^(-)水平均高于2^(+)本组输血前及对照组输血后,Ca显著低于本组输血前及对照组输血后,存在明显差异(P<0.05)。观察组输血后DBil、TBil、LDH、ALT、AST均显著高于本组输血前及对照组输血后,存在明显差异(P<0.05)。对照组输血前后PT、APTT、TT、FIB、动脉血pH、血乳酸、碱剩余、Na^(+)、K^(+)、Cl^(-)、Ca^(2+)、DBil、TBil、LDH、ALT、AST比较,未见显著差异(P>0.05)。结论大量输血尽管对挽救患者生命及促进后续治疗具有积极作用,但将导致患者凝血功能、血气分析、生化指标及血清电解质水平发生明显变化,输血前后均应做好患者各项生化指标的监测与比较工作,在保障治疗效果的基础上进Objective To discuss the impact of massive blood transfusions on various biochemical indicators in patients.Methods 100 patients who received blood transfusion treatment were divided into a control group(blood transfusion volume≤2000 ml)and an observation group(blood transfusion volume>2000 ml)based on blood transfusion volume,with 50 patients in each group.Comparison was made on coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)],blood gas analysis indicators[arterial pH,lactate,base excess],serum electrolyte levels[sodium ion(Na^(+)),potassium ion(K^(+)),chloride ion(Cl^(-)),calcium ion(Ca^(2+))],biochemical indicators[direct bilirubin(DBil),total bilirubin(TBil),lactate dehydrogenase(LDH),alanine aminotrasferase(ALT),aspartate transaminase(AST)]before and after blood transfusion between the two groups.Results PT,APTT,TT and FIB after transfusion in the observation group were(24.12±6.63)s,(24.94±6.81)s,(27.01±5.42)s and(1.63±0.61)g/L,and those in the control group were(16.80±3.31)s,(37.41±13.89)s,(17.11±2.01)s and(2.76±1.38)g/L.PT and TT after transfusion in the observation group were longer than those in this group before transfusion and those in the control group after transfusion,APTT was shorter than that before transfusion and that in the control group after blood transfusion,and FIB was lower than that before transfusion and that in the control group after blood transfusion.There was a significant difference(P<0.05).The arterial pH,lactate and base excess in the observation group after blood transfusion were lower than those in this group before blood transfusion and those in the control group after blood transfusion,and the base excess was higher than that in this group before blood transfusion and that in the control group after blood transfusion.There was significant difference(P<0.05).The levels of Na^(+),^(+)-K and Cl in the observation group after blood transfusion were higher than those in this group before bl

关 键 词：大量输血 凝血功能 生化指标 电解质水平 血气分析 

分 类 号：R457.1[医药卫生—治疗学]