摘要
目的 探析机采血小板与冷沉淀单独及其联合输注对大失血患者凝血功能的影响。方法 选择我院2013年6月～2015年6月收治90例大出血患者作为研究对象,根据患者输血方式的不同分为机采血小板联合冷沉淀组（A组,n=42）、单独机采血小板组（B组,n=28）及单独冷沉淀组（C组,n=20）。三组均分别于输注前1 h内及输注后24 h内采集5 ml静脉血,测定PT（凝血酶原时间）、a PTT（活化部分凝血酶原时间）、TT（凝血酶时间）、Fbg（纤维蛋白原）等凝血功能指标及PLT（血小板计数）,比较平均止血时间、住院时间。结果 三组输注前各项指标间无明显差异（P〉0.05）,输注后,三组PT、a PTT、TT均降低,Fbg与PLT升高,组内前后差异有统计学意义（P〈0.05）,同时输注后A组PT、a PTT、TT均为三组中最低,其次为C组,A组Fbg与PLT为三组中最高,其次为B组,三组间差异的两两比较均有统计学意义（P〈0.05）。三组24 h红细胞的输注量无明显差异（P〉0.05）,A组血小板输注量低于B组,冷沉淀输注量低于C组,差异均有统计学意义（P〈0.05）。三组平均止血时间为A组最低,其次为B组及C组,三组间两两差异均有统计学意义（P〈0.05）;住院时间A组最短,与B组及C组比较均有统计学意义（P〈0.05）,B组与C组间差异无统计学意义（P〉0.05）。结论 急性大失血采取机采血小板联合冷沉淀输注可为失血患者及时补充血小板及多种凝血因子,并缓解凝血障碍,实现快速止血,利于患者更快恢复,同时也减少了成分血用量,为理想治疗方案。
Objective To explore the effect of machine-gathered blood platelet and cryoprecipitate a- lone and the combined infusion of the two on coagulation function in patients with massive blood loss. Methods 90 patients with massive blood loss treated in our hospital from June 2013 to June 2015 were selected as the research objects. According to the different forms of blood transfusion, the patients were divided into the ma- chine- gathered blood platelet combined with cryoprecipitate group （ group A, n =42 ）, the machine- gathered blood platelet alone group（ group B, n = 28 ）and the cryoprecipitate group （group C, n = 20）. In 1 h before in- fusion and 24 h after infusion,5 ml venous blood of the three groups was collected ,respectively. The coagula- tion function indexes such as PT（ prothrombin time）, aPTT（ activated partial thromboplastin time）, TT（ throm- bin time）and Fbg（fibrinogen） were determined. The average hemostasis time and length of hospital stays were compared. Results Before infusion, there were no significant differences of indexes between the three groups （ P 〉 0.05 ）. After infusion, the PT, aPTT and TT of the three groups decreased while Fbg and PLT increased and the before and after differences were statistically significant （ P 〈 0. 05 ）. Besides, after infusion, PT, aPTT and TT of group A were the lowest in the three groups, followed by group C. Fbg and PLT of group A were the highest in the three groups,followed by group B. The differences between any two groups of the three groups were statistically significant（ P 〈 0. 05 ）. There were no significant differences in 24 h infused volume of red blood cells between the three groups （ P 〉 0. 05 ）. The infused volume of platelet of group A was lower than that of group B and the infused volume of cryoprecipitate was lower than that of group C （ P 〈 0. 05 ）. The aver-
age hemostasis time of group A was the lowest in the three groups, followed by group B and group C and was lower than that of（P
出处
《血栓与止血学》
2016年第3期321-323,326,共4页
Chinese Journal of Thrombosis and Hemostasis
关键词
大失血
机采血小板
冷沉淀
凝血功能
Massive blood loss
Machine-gathered blood platelet
Cryoprecipitate
Coagulation function
