血浆与红细胞不同比例输注对大量失血患者凝血功能及预后的影响分析  

Analysis of the Influence of Different Proportion of Plasma and Red Blood Cell Infusion on Coagulation Function and Prognosis of Patients with Mas⁃sive Blood loss

作　　者：邓瑜颖 陈会慧 成文华 DENG Yuying;CHEN Huihui;CHENG Wenhua(Department of Blood Transfusion,Yancheng First Hospital Affiliated of Nanjing University Medicine College(Yancheng first People's Hospital),Yancheng 224000,Jiangsu,China;Department of Hematology,Yancheng First Hospital Affiliated of Nanjing University Medicine College(Yancheng first People's Hospital),Yancheng 224000,Ji-angsu,China)

机构地区：[1]南京大学医学院附属盐城第一医院(盐城市第一人民医院)输血科,江苏盐城224000 [2]南京大学医学院附属盐城第一医院(盐城市第一人民医院)血液科,江苏盐城224000

出　　处：《系统医学》2024年第17期63-66,共4页Systems Medicine

摘　　要：目的研究和分析血浆与红细胞不同比例输注对大量失血患者凝血功能及预后的影响。方法非随机选取2021年1月—2023年12月在南京大学医学院附属盐城第一医院(盐城市第一人民医院)接受治疗的140例大量失血患者作为研究对象,根据输注比例不同进行分组,每组70例。A组采取100 mL新鲜冰冻血浆(fresh frozen plasma,FFP)∶1 U红细胞悬液(red blood cell suspension,RBCs)的输注比例,B组采取100 mL FFP∶1.5 U RBCs输注比。对比两组输注后血常规指标[血红蛋白(hemoglobin,Hb)、血小板(blood platelet,PLT)]水平、输注量(FFP、冷沉淀、血小板)及输注前后凝血功能指标[纤维蛋白原(fibrinogen,Fbg)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)]水平变化。结果输注24 h后,两组Hb水平升高、PLT水平降低,但A组均高于B组,差异有统计学意义(P均<0.05)。A组FFP输注量为(11.47±0.76)mL/kg,低于B组的(17.39±1.38)mL/kg,差异有统计学意义(t=31.439,P<0.05)。两组冷沉淀、血小板输注量比较,差异无统计学意义(P均>0.05)。输注24 h后,两组Fbg水平降低,但A组高于B组;两组PT、APTT水平升高,但A组低于B组,差异有统计学意义(P均<0.05)。结论血浆与红细胞1∶1的输注比例,可快速改善大量失血患者的血常规,对凝血功能的影响更小,血浆输注量更少。Objective To study and analyze the effect of different proportion of plasma and red blood cell infusion on coagulation function and prognosis of patients with massive blood loss.Methods 140 patients with massive blood loss treated in the Yancheng First Hospital Affiliated of Nanjing University Medicine College(Yancheng first People's Hos-pital)from January 2021 to December 2023 were non-randomly selected as the study subjects.They were divided into group A(n=70)and group B(n=70)by different proportion of infusion.Group A received 100 mL fresh frozen plasma(FFP)∶1 U red blood cell suspension(RBCs),and group B received 100 mL FFP∶1.5 U RBCs.The levels of blood routine indexes[hemoglobin(Hb)and blood platelet(PLT)],infusion volume(FFP,cryoprecipitate,platelets)and co-agulation function indexes[fibrinogen(Fbg),prothrombin time(PT),and activated partial thromboplastin time(APTT)]before and after infusion were compared between the two groups.Results After 24 h infusion,Hb level increased and PLT level decreased in both groups,but group A were higher than group B,the differences were statistically signifi-cant(all P<0.05).The FFP infusion volume in group A was(11.47±0.76)mL/kg,lower than that in group B(17.39±1.38)mL/kg,and the difference was statistically significant(t=31.439,P<0.05).There were no statistically significant differences in the amount of cryoprecipitation and platelet transfusion between the two groups(both P>0.05).After 24 h of infusion,Fbg levels in both groups were decreased,but group A were higher than group B,the levels of PT and aPTT were increased in both groups,but group A were lower than group B,the differences were statistically significant(all P<0.05).Conclusion The 1∶1 infusion ratio of plasma to red blood cell can improve the routine blood of patients with massive blood loss rapidly,have less influence on coagulation function,and reduce the amount of plasma infu-sion.

关 键 词：血浆 红细胞 输注比例 大量失血 凝血功能 预后 

分 类 号：R4[医药卫生—临床医学]