摘要
目的探不同输血方式对急性大失血患者临床疗效及安全性的影响,从而得出最合理的输血治疗方式,使临床用血更加科学合理有效。方法选取2017年7月-2019年7月来河南科技大学第一附属医院救治的因严重创伤、消化道破裂、异位妊娠破裂、肝脾破裂等原因的急性大出血115例患者作为研究对象。根据输血治疗方式不同分为对照组I(35例)、对照组II(41例)和实验组(39例);对照组1接受联合输注新鲜冰冻血浆和单采血小板;对照组2接受单独输注冷沉淀凝血因子治疗;实验组接受联合输注单采血小板和冷沉淀凝血因子治疗,比较三组患者的有效止血率、平均止血时间、24h内悬浮红细胞续用量、输血治疗前后凝血四项指标(FIB、PT、TT、APTT)、治疗前后血常规指标变化(HGB、HCT、PLT)以及不良反应情况。结果输血后,实验组血常规指标变化及凝血指标均明显优于对照组I和对照组II,差异有统计学意义(P<0.05);实验组的平均止血时间和24 h内悬浮红细胞续用量较其他两组明显减少,有效止血率较其对照组I和对照组II明显提高,数据具有统计学意义(P<0.05);不良反应发生率(5.13%),明显低于对照组I(25.71%)和对照组II(19.51%),差异有统计学意义(P<0.05)。结论在急性大量输血患者的临床救治中,按比例输注各种血液成分的输血治疗能够改善凝血功能,缓解临床病情,是临床上应该采取的输血治疗方式。
Objective To explore the influence of different blood transfusion methods on the clinical efficacy and safety of patients with acute major blood loss,so as to obtain the most reasonable blood transfusion treatment method,making clinical blood use more scientific,rational and effective.Methods From July 2017 to July 2019,115 patients with acute massive hemorrhage due to severe trauma,gastrointestinal rupture,ectopic pregnancy rupture,liver and spleen rupture were selected as the research objects.They were divided into the control group I(35 cases),the control group II(41 cases)and the experimental group(39 cases);the control group I received combined infusion of fresh frozen plasma and apheresis platelets;the control group II received separate infusion of cryoprecipitated coagulation factor;the experimental group received combined transfusion of apheresis platelets and cryoprecipitated coagulation factor.The effective hemostatic rate,mean hemostasis time,and the clinical efficacy of the three groups were compared.The continuous dosage of suspended red blood cells within 24 hours,four coagulation indexes(FIB,Pt,TT,APTT)before and after blood transfusion treatment,changes of blood routine indexes(Hgb,HCT,PLT)before and after treatment,and adverse reactions.Results After blood transfusion,the changes of blood routine indexes and coagulation indexes in experimental group were significantly better than that of the control group I and the control group II,the difference was statistically significant(P<0.05);the average hemostatic time and coagulation index of experimental group were significantly higher than that of the control group I and II(P<0.05).The effective hemostatic rate was significantly higher than that of the control group I and the control group II(P<0.05);the incidence of adverse reactions(5.13%)was significantly lower than that of the control group I(25.71%)and the control group II(19.51%),with statistically significant difference(P<0.05).Conclusion In the clinical treatment of patients with acute massive blood transfusion,the transfusion therapy of infusion of various blood components in proportion can improve the coagulation function and alleviate the clinical condition,which is the blood transfusion treatment method that should be adopted in clinic.
作者
苏慧
SU Hui(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)
出处
《新疆医学》
2020年第7期700-703,共4页
Xinjiang Medical Journal
关键词
急性大失血
输血治疗
联合输注
Acute Massive Blood Loss
Blood Transfusion
Combined Infusion
作者简介
苏慧,女,检验技师,研究方向:输血、检验、血液。
