摘要
目的:探讨不同血浆(FFP)与红细胞(RBC)输注比例对创伤后大出血患者救治效果及凝血功能的影响。方法:选取125例创伤后大出血患者为研究对象,按照救治时FFP/RBC输注比例不同分为A组(n=42)、B组(n=44)和C组(n=39)。A组输注比例0.5~1.0;B组输注比例>1.0~1.5;C组输注比例>1.5~2.0。比较各组患者救治效果(入院24 h死亡率、ICU停留时间及住院时间)、血常规[血红蛋白(Hb)、血小板计数(Plt)水平]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及国际标准化比值(INR)水平]、纤溶功能[D-二聚体(D-D)、蛋白C(PC)及纤维蛋白降解产物(FDP)水平]及血制品输注量。结果:各组患者入院24 h死亡率、ICU停留时间及住院时间无统计学差异(P>0.05)。输血后,各组患者APTT、PT、Plt、D-D、INR、PC水平比较:A组<B组<C组(P<0.05)。各组患者FFP输注量比较:A组>B组>C组(P<0.05)。结论:救治创伤后大出血患者过程中推荐FFP/RBC的输注比例为>1.0~1.5,在保证救治效果的前提下,能有效促进凝血功能恢复,节约血制品。
Objective:To discuss the impacts of different ratios of fresh frozen plasma(FFP)to red blood cell(RBC)transfusion on treatment effects and coagulation function in patients with post-traumatic massive bleeding.Methods:The clinical data of 125 patients with post-traumatic massive bleeding were analyzed retrospectively.The transfused FFP/RBC ratio was between 0.5 and 2.0 during the treatment.The patients were divided into group A(n=42,transfusion ratio of 0.5~1.0),group B(n=44,transfusion ratio>1.0~1.5)and group C(n=39,transfusion ratio>1.5~2.0).The treatment effects(24-hour mortality rate,ICU stay time,and length of hospital stay),blood routine[hemoglobin(Hb),platelet count(Plt)levels],coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),and international normalized ratio(INR)levels],fibrinolysis function[D-dimer(D-D),protein C(PC),and fibrinolytic degradation product(FDP)levels]and transfused volume of blood products were compared between the groups.Results:There was no statistically significant difference in the 24-hour mortality rate,ICU stay time,and hospitalization time among the groups(P>0.05).After blood transfusion,APTT,PT,Plt,D-D and PC in group A were shorter/lower than those in group B.APTT,PT,INR,D-D and PC in group B were shorter/lower than those in group C,and Plt was higher than that in group C(P<0.05).The transfused volume of FFP in group A was larger than that in group B,and the transfused volume of FFP in group B was larger than that in group C(P<0.05).Conclusion:The recommended transfusion ratio of FFP/RBC in the treatment of patients with post-traumatic massive bleeding is>1.0~1.5,it can effectively promote the recovery of coagulation function while ensuring the treatment effect.In addition,it can effectively save blood products.
作者
刘慧如
何颖
周园园
LIU Hui-ru;HE Ying;ZHOU Yuan-yuan(Department of Blood Transfusion,the First People's Hospital of Lianyungang,Lianyungang 222000,Jiangsu,China)
出处
《川北医学院学报》
CAS
2024年第4期544-547,共4页
Journal of North Sichuan Medical College
关键词
血浆与红细胞输注比例
救治效果
回顾性研究
创伤后大出血
凝血功能
Ratio of plasma to red blood cell transfusion
Treatment effect
Retrospective study
Post-traumatic massive bleeding
Coagulation function
