摘要
目的 探讨限制性输血与开放性输血两种方式在重度烧伤患者中的临床价值。方法 回顾性选取2021年7月—2023年6月徐州医科大学附属医院收治的84例患者的临床资料,根据非休克期所用输血策略,将其分为观察组(限制性输血,n=42)与对照组(开放性输血,n=42)。比较两组输血情况、凝血酶时间(Thrombin Time,TT)、凝血酶原时间(Prothrombin Time,PT)、纤维蛋白原(Fibrinogen,FIB)、不良事件发生率。另对两组输血有效性进行比较,两组患者输血前后均完成红细胞计数(Red blood Cell Count,RBC)、血红蛋白(Haemoglobin,Hb)、血细胞比容(Haematocrit,Hct)水平检测,计算每单位红细胞输注对应变化量△RBC、△Hb、△Hct。结果 观察组红细胞用量为(11.67±4.23)U,低于对照组的(20.85±5.38)U;观察组血浆用量为(40.62±11.35)U,低于对照组的(68.05±13.27)U,差异有统计学意义(t=8.693,10.180,P均<0.05)。观察组△RBC、△Hb高于对照组,差异有统计学意义(P均<0.05);两组△Hct比较,差异无统计学意义(P>0.05)。治疗后72 h,观察组PT、TT水平均低于对照组,FIB水平高于对照组,差异有统计学意义(P均<0.05)。两组不良事件总发生率比较,差异无统计学意义(P>0.05)。结论 在重度烧伤患者输血期间,限制性输血的总有效性较高,可降低红细胞、血浆用量,改善患者凝血功能,且安全性较好。
Objective To investigate the clinical value of restricted blood transfusion and open blood transfusion in severe burn patients.Methods The clinical data of eighty-four patients admitted in the Affiliated Hospital of Xuzhou Medical University from July 2021 to June 2023 were retrospectively selected and were divided into observation group(restricted transfusion,n=42) and control group(open transfusion,n=42) according to transfusion strategies used in the non-shock phase.Blood transfusion,thrombin time(TT),prothrombin time(PT),fibrinogen(FIB) and incidence of adverse events were compared between the two groups.The effectiveness of blood transfusion was compared between the two groups.The red blood cell count(RBC),haemoglobin(Hb) and haematocrit(Hct) levels were detected before and after transfusion in two groups.The corresponding changes △RBC,△Hb,△Hct for each unit of red blood cell infusion were calculated.Results The erythrocyte consumption in the observation group was(11.67±4.23) U,lower than that in the control group [(20.85±5.38) U].The plasma dosage of the observation group was(40.62±11.35) U,lower than that of the control group [(68.05±13.27) U],and the differences were statistically significant(t=8.693,10.180,both P<0.05).The △RBC and △Hb in the observation group were higher than those in the control group,and the differences were statistically significant(both P<0.05),but there was no statistically significant difference in △Hct between the two groups(P>0.05).72 h after treatment,the PT and TT levels in the observation group were lower than those in the control group,and the FIB levels were higher than those in the control group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion During the transfusion of severe burn patients,the total effectiveness of restricted transfusion is higher,which can reduce the amount of red blood cells and plasma,improve
作者
王淑雅
张盼
林子曦
WANG Shuya;ZHANG Pan;LIN Zixi(Department of Blood Transfusion,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province,221000 China;Department of Burns and Plastic Surgery,the 71st Group Army Hospital of CPLA Army,Xuzhou,Jiangsu Province,221000 China)
出处
《系统医学》
2024年第4期75-78,共4页
Systems Medicine
关键词
重度烧伤
输血治疗
限制性输血
输血量
输血有效性
Severe burns
Blood transfusion therapy
Restricted blood transfusion
Amount of blood transfused
Transfusion effectiveness
