摘要
目的 探讨大量输血程序（massive transfusion protocols,MTP）对腹部外科创伤性休克患者的治疗效果. 方法 将133例腹部外科创伤性休克患者分为对照组74例MTP组59例,分析比较2组一般资料、输血量、输血比例、24 h血常规、凝血功能、输血相关并发症的发生率及死亡率.结果 对照组（非MTP实施前）74例入院24 h内平均输注红细胞悬液19.5U,平均输注新鲜冰冻血浆12.6U,RBC∶FFB为1.55∶1.8例患者输注血小板,11例患者输注冷沉淀.MTP组59例入院24 h内平均输注红细胞悬液17.3U,RBC∶FFB为1∶1.32例患者输注血小板,35例患者输注冷沉淀.2组入院时PT、APTT、Hb、PLT比较,差异无统计学意义（P＞0.05）.24 h结果2组比较,Hb差异无统计学意义（P＞0.05）,而2组之间PT、APTT、PLT比较,均差异有统计学意义（P＜0.05）.对照组发生输血相关并发症11例（14.9％）,死亡7例（9.46％）.MTP组发生输血相关并发症7例（11.9％）,死亡4例（6.78％）.结论 大量输血程序能够早期改善腹部外科创伤性休克患者的凝血功能,减少术后患者的输血量,提高腹部外科创伤性休克患者的生存率.
Objective To investigate the clinical value of the massive transfusion protocols （MTP） in abdominal surgical patients with traumatic shock.Methods An analysis was made on the clinical data of patients before and after the use of MTP,including the general condition,amount of blood transfusion,transfusion components and ratio,blood and coagulation function test,and blood transfusion related complications and mortality.Results Before implement of MTP,the average RBC transfusion in the first 24 hours was 19.5U,FFBwas 12.6U,and the ratio ofRBC ∶ FFB was 1.55 ∶ 1.After implement of MTP,the average RBC transfusion in the first 24 hours was 17.3 U,and the ratio of RBC：FFB was 1 ∶ 1.There were no significant statistical differences between the two groups about PT,APTT,Hb and PLT on admission.After 24 hours of admission,there was no significant difference in Hb between the two groups,there were significant differences of PT,APTT and PLT.Blood transfusion related complications were 11 （14.9％） in control group and 7 （11.9％） in MTP,group,and the mortality was 9.46％ and 6.78％ respectively.Conclusions MTP improves blood coagulation function,reduces blood transfusion and enhances survival rate of abdominal surgical patients with traumatic shock.
出处
《中华普通外科杂志》
CSCD
北大核心
2014年第9期715-718,共4页
Chinese Journal of General Surgery
关键词
腹部损伤
休克
创伤性
输血
Abdominal injuries
Shock, traumatic
Blood transfusion
