摘要
目的探讨大量输血后患者相关指标变化及临床意义。方法选取2016年2月至2017年4月就诊的外伤性大量输血患者87例,观察患者输血前后凝血功能[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)]、电解质[钠离子(Na^+)、钾离子(K^+)、钙离子(Ca^(2+))、氯离子(Cl^-)、镁离子(Mg^(2+))]、炎性因子[白细胞介素-6 (IL-6)、IL-1、IL-8和肿瘤坏死因子α(TNF-α)]、肝肾功[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、尿素氮(BUN)、肌酐(Cr)]和尿酸(UA)]。结果患者输血后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和国际标准化比值(INR)分别为(17. 03±2. 20) s、(40. 10±5. 10) s、(18. 40±3. 81) s和(1. 48±0. 46),较输血前明显升高(P <0. 05),而FIB为(2. 22±0. 87) g/L,较输血前明显降低(P <0. 05);患者输血后IL-6、IL-8和TNF-分别为(114. 06±11. 51) pg/ml、(0. 76±0. 10) pg/ml和(1. 90±0. 24) pg/ml,较输血前明显升高(P <0. 05);患者输血后ALT和AST分别为(103. 06±40. 54) U/L和(118. 36±45. 52) U/L,较输血前明显升高(P <0. 05);患者输血后K^+、Ca^(2+)和Mg^(2+)分别为(3. 90±0. 48) mmol/L、(1. 90±0. 19) mmol/L和(0. 71±0. 12) mmol/L,较输血前明显降低(P <0. 05);输血前后IL-1、TBIL、BUN、Cr、UA、Na^+和Cl^-比较差异无统计学意义(P> 0. 05)。结论大量输血可导致患者内环境改变,应及时监测患者凝血功能、肝功以及电解质等,以防止电解质紊乱、凝血功能障碍等不良反应发生。
Objective To investigate the changes and clinical significance of related indexes in patients after massive transfusion. Methods A total of 87 patients with trauma who received massive transfusion in our hospital from February 2016 to April 2017 were enrolled in the study. The blood coagulation function indexes before and after blood transfusion were observed,that included prothrombin time （PT）, thrombin time （TT）, activated partial thromboplastin time （APTT）, international normalized ratio （INR） ,and electrolytes including sodium ion （Na^＋ ）, potassium ion （K^＋ ）, calcium （Ca^2＋ ）, chloride （C1）, magnesimn ion （Mg^2＋ ）, as well as itfflammatory eytokine including interleukin-6 （IL-6）, IL-1, IL-8 and tmnor necrosis factor （TNF）, and liver and kidney function indexes including alanine aminotransferase （ALT）, aspartate aminotransferase （ AST）, total bilirubin （ TBIL）, urea nitrogen （ BUN）, ereatinine （Cr） and uric acid （UA）. Results After blood transfusion,PT APTr,TT and INR were （17.03 ±2.20） s, （40.10 ±5.10） s, （18.40 ±3.81）s and （1.48 ±0.46）, respectively, which were significantly higher than those before blood transfusion （ P 〈 0.05 ）, and FIB （2.22 ±0.87 ） g/L was significantly lower than that before blood transfusion （ P 〈 0.05 ）. After blood transfusion, the levels of IL-6, IL-8 and TNF were （ 114.06 ± 11.51 ） pg/ml, （ 0.76 ± 0. 10） pg/ml and （ 1.90 ±0.24 ） pg/ml, respectively, which were significantly higher than those before blood transfusion （ P 〈 0.05 ）. After blood transfusion, ALT and AST were （ 103.06 ± 40.54） U/L and （118.36 ±45.52）U/L, respectively, which were significantly higher than those before transfusion （P 〈 0.05 ）, and the levels of K ^＋ , Ca^2 ＋ and Mg^2＋ were （ 3.90 ±0.48 ） mmol/L, （ 1.90 ±0.19） mmol/L and （0.71 ±0.12） mmol/L, respectively, which were significantly lower than those before blood transfusion （ P 〈 0.05
作者
羊文芳
王雯
YANG Wefang;WANG Wen(Blood Bank,Central Hospital of Western Part of Hainan Province,Hainan,Yanzhou 571700,China)
出处
《河北医药》
CAS
2018年第24期3795-3797,3801,共4页
Hebei Medical Journal
基金
海南省医学科学研究重点课题(编号:琼卫-2014-PT-35)
关键词
大量输血
凝血功能
电解质
肝肾功
炎性因子
massive blood transfusion
coagulation function
electrolyte
liver and kidney function
inflanmlatoryfactors
