文章摘要

创伤大出血患者住院输血治疗中不同成分输血比例的救治效果

作者: 1荣发芝
1 池州市人民医院输血科,安徽 池州 247000
通讯: 荣发芝 Email: 164673239@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.04.020

摘要

目的:探讨创伤大出血患者住院输血治疗中不同成分输血比例的救治效果。方法:回顾性分析2016年1月至2021年7月池州市人民医院救治97例创伤大出血患者的相关资料,依据输注新鲜冰冻血浆(fresh frozen plasma,FFP)与悬浮红细胞(red blood cells suspension,RBCS)的不同比例,分成A组(≤1:2,n=28)、B组(>1:2~1:1,n=35)和C组(>1:1,n=34)。对3组血制品用量、凝血功能指标和预后情况进行比较分析。结果:与输血前比较,A组输血后凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial prothrombin time,APTT)和国际标准化比值(international normalized ratio,INR)均明显延长,B组、C组输血前后PT、APTT、INR无明显变化(P>0.05),A组输血后PT、APTT、INR高于B组和C组,差异均有统计学意义(均P<0.05),B组和C组输血后PT、APTT、INR比较,差异无统计学意义(P>0.05)。A组、B组和C组住院期FFP输注量依次明显增加(P<0.05),两两比较差异有统计学意义(P<0.05)。3组住院时间、重症监护室(intensive care unit,ICU)停留时间和入院24 h、30 d病死率比较,差异无统计学意义(P>0.05)。结论:推荐按FFP:RBCS为1:2~1:1输血治疗创伤大出血患者,不影响救治效果,但可减轻凝血功能异常和节约血液制品。
关键词: 创伤大出血;新鲜冰冻血浆;悬浮红细胞;比例;凝血功能;死亡

Evaluation of the therapeutic effect of different proportions of blood transfusion in patients with traumatic massive hemorrhage

Authors: 1RONG Fazhi
1 Department of Blood Transfusion, Chizhou People's Hospital, Chizhou Anhui 247000, China

CorrespondingAuthor: RONG Fazhi Email: 164673239@qq.com

DOI: 10.3978/j.issn.2095-6959.2022.04.020

Abstract

Objective: To explore the effect of different proportions of blood transfusion in the treatment of patients with traumatic massive hemorrhage. Methods: The data of 97 patients with traumatic massive hemorrhage treated in Chizhou People’s Hospital from January 2016 to July 2021 were retrospectively analyzed. According to the different proportions of fresh frozen plasma (FFP): red blood cells suspension (RBCs), they were divided into group A (≤1:2, n=28), group B (>1:2–1:1, n=35) and group C (>1:1, n=34). The dosage of blood products, coagulation function and prognosis of the three groups were compared and analyzed. Results: Compared with before blood transfusion, PT, APTT and INR in group A were significantly prolonged. There were no significant changes in PT, APTT and INR before and after blood transfusion in group B and group C (P>0.05). PT, APTT and INR after blood transfusion in group A were higher than those in group B and group C (P<0.05), but there was no significant difference in PT, APTT and INR between group B and group C (P>0.05). The amount of FFP infusion in group A, group B and group C during hospitalization increased significantly in turn (P<0.05), and the difference between the two groups was statistically significant (P<0.05). There was no significant difference in hospital stay, ICU stay, 24 h and 30 d mortality among the three groups (P>0.05). Conclusion: It is recommended that FFP: RBCs 1:2–1:1 blood transfusion be used to treat patients with traumatic massive hemorrhage, which can reduce coagulation dysfunction and save blood products without affecting the treatment effect.
Keywords: traumatic massive hemorrhage; fresh frozen plasma; red blood cells suspension; proportion; coagulation function; death