常规凝血指标检验对异位妊娠大出血患者输血不良反应的监测价值研究  

Study on the Monitoring Value of Routine Coagulation Indicators in Blood Transfusion Adverse Reactions in Patients with Ectopic Pregnancy and Major Hemorrhage

作　　者：王真怡 马聪 WANG Zhenyi;MA Cong(Department of Laboratory,Luoyang Maternal and Child Health Hospital,Luoyang Henan 471000,China)

机构地区：[1]洛阳市妇幼保健院检验科,河南洛阳471000

出　　处：《临床研究》2025年第3期135-139,共5页Clinical Research

摘　　要：目的探究出现大出血的异位妊娠患者的临床输血期间,应用常规凝血指标检验的监测价值。方法选取洛阳市妇幼保健院2023年4月至2024年5月期间收入的78例异位妊娠病例,且均发生大出血情况,并展开回顾性研究,依据是否发生输血不良反应,将其分为对照组(n=68,未发生输血不良反应)、研究组(n=10,发生输血不良反应),均进行常规凝血指标检验,并分析其在常规凝血指标方面的差异性,并进行多因素Logistic回归分析,评估发生输血不良反应影响因素。结果输血前,两组常规凝血指标比较,差异均无统计学意义(P>0.05),输血后,研究组凝血酶原时间、凝血酶原活动度、国际标准化比值、活化部分凝血活酶时间、凝血酶时间、D-二聚体、纤维蛋白(原)降解产物均高于对照组,纤维蛋白原测定以及抗凝血酶活性均低于对照组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,输血后凝血酶原时间延长;凝血酶原活动度增高;国际标准化比值增高;活化部分凝血活酶时间延长;凝血酶时间延长;纤维蛋白原测定降低;D-二聚体增高;纤维蛋白(原)降解产物增高;抗凝血酶活性降低均为输血不良反应的影响因素(P<0.05)。结论出现大出血的异位妊娠患者的临床输血期间,应用常规凝血指标检验的监测价值较为理想,能够指导临床及时发现输血不良反应,具有临床应用意义。Objective To explore the monitoring value of routine coagulation indicators during blood transfusion in patients with ectopic pregnancy experiencing major hemorrhage.Methods A retrospective study was conducted on 78 cases of ectopic pregnancy with major hemorrhage admitted to Luoyang Maternal and Child Health Hospital from April 2023 to May 2024.Based on whether adverse reactions to transfusion occurred,the patients were divided into a control group(n=68,no transfusion adverse reactions)and a study group(n=10,experiencing transfusion adverse reactions).Routine coagulation indicator tests were performed for both groups,and differences in routine coagulation indicators were analyzed.Multivariate logistic regression analysis was used to assess the influencing factors for adverse transfusion reactions.Results There were no statistically significant differences in routine coagulation indicators between the two groups before transfusion(P>0.05).However,after transfusion,the study group had higher prothrombin time,prothrombin activity,international normalized ratio,activated partial thromboplastin time,thrombin time,D-dimer levels,and fibrin(ogen)degradation products compared to the control group,while fibrinogen levels and antithrombin activity were lower in the study group,with statistical significance(P<0.05).The multivariate logistic regression analysis revealed that prolonged prothrombin time,increased prothrombin activity,elevated international normalized ratio,prolonged activated partial thromboplastin time,prolonged thrombin time,reduced fibrinogen levels,increased D-dimer levels,elevated fibrin(ogen)degradation products,and decreased antithrombin activity were all factors influencing transfusion adverse reactions(P<0.05).Conclusion The monitoring value of routine coagulation indicator tests during clinical transfusions in patients with ectopic pregnancy experiencing major hemorrhage is significant,allowing for timely detection of transfusion adverse reactions,and has important clinical application significance.

关 键 词：异位妊娠 输血不良反应 凝血指标检验 出血 监测价值 

分 类 号：R457.1[医药卫生—治疗学]