不同比例悬浮红细胞及新鲜冰冻血浆对急性创伤大量输血患者凝血纤溶功能、预后的影响  

Effects of different proportions of suspended red blood cells and fresh frozen plasma on coagulation and fibrinolysis function and prognosis in patients with acute trauma undergoing massive blood transfusion

作　　者：王静[1] 宋进进 WANG Jing;SONG Jinjin(Blood Transfusion Department,Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,Yulin 719000,China)

机构地区：[1]西安交通大学第一附属医院榆林医院输血科,陕西榆林719000

出　　处：《临床医学研究与实践》2024年第35期118-121,共4页Clinical Research and Practice

摘　　要：目的探讨不同比例悬浮红细胞(SRBC)及新鲜冰冻血浆(FFP)对急性创伤大量输血患者凝血纤溶功能、预后的影响。方法选取2021年3月至2023年3月我科收治的100例急性创伤大量输血患者为研究对象,根据输入SRBC及FFP的比例不同将其分为A组和B组,各50例。A组SRBC∶FFP为1∶1,B组SRBC∶FFP为2∶1。比较两组的治疗效果。结果输血后,A组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于B组,纤维蛋白原(FIB)水平高于B组(P<0.05)。输血后,A组的蛋白C(PC)、D-二聚体(D-D)水平高于B组(P<0.05);输血后,两组的纤维蛋白原降解产物(FDP)水平无明显差异(P>0.05)。两组的输血不良反应总发生率无明显差异(P>0.05)。A组的序贯器官衰竭评估(SOFA)评分低于B组(P<0.05);两组的住院时间无明显差异(P>0.05)。结论SRBC∶FFP按1∶1的比例输注可更好地维持急性创伤大量输血患者的凝血纤溶功能,改善预后,且安全性高,值得推广。Objective To explore the effects of different proportions of suspended red blood cells(SRBC)and fresh frozen plasma(FFP)on coagulation and fibrinolysis function and prognosis in patients with acute trauma undergoing massive blood transfusion.Methods A total of 100 patients with acute trauma undergoing massive blood transfusion admitted from March 2021 to March 2023 in our department were selected as the research objects.According to the input proportion of SRBC and FFP,the patients were divided into group A and group B,with 50 cases in each group.The SRBC∶FFP of the group A was 1∶1,and the SRBC∶FFP of the group B was 2∶1.The therapeutic effects of the two groups were compared.Results After blood transfusion,prothrombin time(PT)and activated partial thromboplastin time(APTT)in the group A were shorter than those in the group B,and fibrinogen(FIB)level was higher than that in the group B(P<0.05).After blood transfusion,the levels of protein C(PC)and D-dimer(D-D)in the group A were higher than those in the group B(P<0.05);after blood transfusion,there was no significant difference in the fibrinogen degradation products(FDP)level between the two groups(P>0.05).There was no significant difference in the total incidence of adverse transfusion reactions between the two groups(P>0.05).The Sequential Organ Failure Assessment(SOFA)score of the group A was lower than that of the group B(P<0.05);there was no significant difference in hospitalization time between the two groups(P>0.05).Conclusion SRBC∶FFP infusion at a ratio of 1∶1 can better maintain the coagulation and fibrinolysis function of patients with acute trauma undergoing massive blood transfusion,improve the prognosis,and has high safety,which is worthy of promotion.

关 键 词：急性创伤 大量输血 悬浮红细胞 新鲜冰冻血浆 凝血纤溶功能 预后 

分 类 号：R641[医药卫生—外科学]