创伤性大出血患者病毒灭活血浆与RBCS不同比例输血治疗的对比研究  

Comparative Study of Virus-inactivated Plasma and RBCS Transfusion Treatment with Different Ratios in Patients with Traumatic Hemorrhage

作　　者：王淑雅 林子曦 徐佳丽 WANG Shuya;LIN Zixi;XU Jiali(Department of Blood Transfusion,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州医科大学附属医院输血科,江苏徐州221000

出　　处：《系统医学》2023年第24期70-74,共5页Systems Medicine

摘　　要：目的探讨创伤性大出血患者中病毒灭活血浆与少白细胞的悬浮红细胞(red blood cells suspension,RBCS)不同比例输血治疗的效果差异。方法回顾性分析2021年7月—2023年6月徐州医科大学附属医院收治的92例创伤性大出血患者的临床资料,根据输注病毒灭活血浆与RBCs的比例进行分组,将其分为高比例组(>1:1,n=32)、中比例组(>1:2~1:1,n=34)、低比例组(≤1:2,n=26),比较3组住院时间(含住院与住ICU)、凝血功能指标[凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial thromboplastin time,APTT)、国际标准化比值(international normalized ratio,INR)、纤维蛋白原(fibrinogen,FIB)]、电解质指标(含钠离子与钾离子)、血制品用量以及病死率。结果高比例组PT、APTT、INR分别为(13.54±1.86)s、(32.87±3.93)s、(1.11±0.25),中比例组分别为(13.48±1.65)s、(33.17±3.35)s、(1.19±0.36),明显低于低比例组的(14.62±1.90)s、(35.45±5.09)s、(1.55±0.34);高比例组的FIB为(2.87±0.59)g/L,中比例组为(2.72±0.54)g/L,明显高于低比例组的(2.07±0.41)g/L,差异有统计学意义(F=3.574、3.306、15.436、18.283,P均<0.05)。3组住院总时间与住ICU时间比较,差异无统计学意义(P均>0.05);治疗后,3组钾离子水平明显升高,钠离子水平明显下降,差异有统计学意义(P均<0.05);3组RBCS用量比较,差异无统计学意义(P>0.05),3组血浆用量比较,差异有统计学意义(P<0.05);3组住院期间与30 d内的病死率比较,差异无统计学意义(P>0.05)。结论大量输血治疗可对创伤性大出血患者的凝血功能及电解质平衡等造成影响,与低比例输血治疗比较,中比例、高比例输血治疗可减轻凝血功能异常与电解质平衡问题,但从节约血液制品角度考虑,推荐按照血浆:RBCS为1:2~1:1。Objective To explore the differences in the effects of different proportions of virus-inactivated plasma and red blood cells suspension(RBCS)with fewer leukocytes in patients with traumatic hemorrhage.Methods The clinical data of 92 patients with traumatic hemorrhage admitted to the Affiliated Hospital of Xuzhou Medical University from July 2021 to June 2023 were retrospectively analyzed and grouped according to the ratio of transfused virus-inactivated plasma to RBCs,which was classified into the high-ratio group(>1:1,n=32),the medium-ratio group(>1:2-1:1,n=34),and the low-ratio group(≤1:2,n=26).The hospitalization time(including hospitalization and ICU stay),coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),international nor⁃malized ratio(INR),fibrinogen(FIB)],electrolyte indexes(including sodium ions and potassium ions),the amount of blood products,and the morbidity and mortality rate were compared among the three groups.Results PT,APTT and INR were(13.54±1.86)s,(32.87±3.93)s and(1.11±0.25)in the high proportion group,and(13.48±1.65)s,(33.17±3.35)s and(1.19±0.36)in the medium proportion group,respectively.It were significantly lower than(14.62±1.90)s,(35.45±5.09)s,(1.55±0.34)in the low proportion group.The FIB of the high proportion group was(2.87±0.59)g/L,and that of the medium proportion group was(2.72±0.54)g/L,which was significantly higher than that of the low pro⁃portion group(2.07±0.41)g/L,and the difference were statistically significant(F=3.574,3.306,15.436,18.283,all P<0.05).There was no significant difference between the total length of hospital stay and ICU stay among the three groups(both P>0.05).After treatment,potassium ion level increased significantly,sodium ion level decreased signifi⁃cantly,and the differences were statistically significant(both P<0.05);There was no significant difference in RBCS dosage among the three groups(P>0.05),but there was significant difference in plasma dosage among the three groups(P<0.05).There was no

关 键 词：创伤性大出血 悬浮少白细胞红细胞 血浆 比例 凝血功能 电解质 

分 类 号：R457[医药卫生—治疗学]