创伤性大出血患者快速输血技术在术中血流动力学稳定性中的应用研究  

Application of Rapid Transfusion Technique in Hemodynamic Stability of Patients with Traumatic Massive Hemorrhage

作　　者：颜天明 徐慧群 YAN Tianming;XU Huiqun(Xiamen University First Affiliated Hospital Blood transfusion department,Xiamen 361100,China;Xiamen Maternal and Child Health Hospital Obstetric thesis,Xiamen 361100,China)

机构地区：[1]厦门大学附属第一医院输血科,福建厦门361100 [2]厦门市妇幼保健院产科,福建厦门361100

出　　处：《中华灾害救援医学》2024年第10期1123-1127,共5页Chinese Journal of Disaster Medicine

基　　金：厦门医疗卫生指导性项目(3502Z20199005)。

摘　　要：目的探讨快速输血技术在创伤性大出血患者术中血流动力学稳定性、输血量、凝血功能及术后并发症发生率中的作用。方法选取2023年1月至2024年5月在厦门大学附属第一医院接受手术治疗的创伤性大出血患者82例,根据随机数字表法,随机将患者分为干预组(采用快速输血技术)和对照组(采用常规输血方法),每组各41例。评估患者术中血流动力学参数、总输血量、纤维蛋白原以及凝血功能,包括凝血酶原时间(Prothrombin Time,PT)、活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT),统计术后并发症如低体温、过敏反应、溶血反应、液体超负荷以及输血相关的急性肺损伤(Transfusion Related Acute Lung Injury,TRALI)的发生情况。结果两组患者术中血流动力学稳定性比较结果显示,干预组的收缩压、舒张压和中心静脉压均显著高于对照组(P<0.05),且心率显著低于对照组(P<0.05)。两组患者总输血量及凝血功能比较结果显示,干预组的总输血量显著低于对照组,PT、APTT显著短于对照组(P<0.05)。干预组的纤维蛋白原水平高于对照组,但不具有统计学意义(P>0.05)。两组患者术后并发症发生率比较结果显示,干预组低体温发生率显著低于对照组(P<0.05)。TRALI、过敏反应、溶血反应、液体超负荷四项并发症,干预组发生率均低于对照组,但不具有统计学意义(P>0.05)。结论快速输血技术能够显著改善术中血流动力学稳定性,减少输血量及低体温发生率,可优化创伤性大出血患者的治疗效果。Objective To investigate the application effect of rapid transfusion technology on intraoperative hemodynamic stability,transfusion volume,coagulation function,and the incidence of postoperative complications in patients with traumatic massive hemorrhage.Methods A total of 82 patients with traumatic massive hemorrhage who underwent surgical treatment at the First Affiliated Hospital of Xiamen University from January 2023 to May 2024 were selected.They were randomly divided into an intervention group(n=41,using rapid transfusion technology)and a control group(n=41,using conventional transfusion methods)based on a random number table.Intraoperative hemodynamic parameters,total transfusion volume,coagulation function(PT,APTT,fibrinogen),and the incidence of postoperative complications(hypothermia,TRALI,allergic reactions,hemolytic reactions,fluid overload)were evaluated.Results The comparison of intraoperative hemodynamic stability between the two groups showed that the intervention group had significantly higher systolic blood pressure,diastolic blood pressure,and central venous pressure compared to the control group(P<0.05),and significantly lower heart rate(P<0.05).The comparison of total transfusion volume and coagulation function between the two groups showed that the intervention group had significantly lower total transfusion volume,and reduced PT and APTT compared to the control group(P<0.05).Although the fibrinogen level in the intervention group was higher than in the control group,it was not statistically significant(P>0.05).The comparison of postoperative complication rates between the two groups showed that the incidence of hypothermia in the intervention group was significantly lower than in the control group(P<0.05).The incidences of TRALI,allergic reactions,hemolytic reactions,and fluid overload were l ower in the intervention group compared to the control group,but these differences were not statistically significant(P>0.05).Conclusion Rapid transfusion technology can significantly improve intraoper

关 键 词：输血 应激障碍 创伤性 急性 血流动力学 手术后并发症 

分 类 号：R457.1[医药卫生—治疗学]