CAJ | 학술논문

目的：探讨外科患者大量输血后不同时间凝血4项指标的变化，动态观察大量输血后对患者凝血功能指标的影响。方法：回顾性分析2011年6月～2013年10月大出血患者32例，男26例，女6例；年龄24～51岁，平均37．5岁。出血原因：肝破裂5例、脾破裂8例、急性上消化道出血3例、重度损伤（多发骨折）14例、产后大出血2例。输血量为2000～4500 ml，平均2800 ml。分别检测其输血前及输血后第1、3、7天的凝血4项指标，对输血前与输血后检测指标进行统计学比较。结果：大量输血后第1天与输血前比较 PT、APTT、TT时间有显著延长（ P＜0．05）， FIB显著降低（P＜0．05）；输血后第3天与输血后第1天比较， PT、APTT、TT时间有显著缩短（P＜0．05）， FIB则显著增高（P＜0．05）；输血后第7天与输血前比较 PT、APTT、TT、FIB无显著性差异（P＞0．05）。结论：外科患者进行大量输血治疗时，应进行凝血4项指标的动态检测，为临床输血治疗提供有力的实验诊断依据，选择适合的成分输血，避免发生凝血功能障碍引起不必要的出血。
목적：탐토외과환자대량수혈후불동시간응혈4항지표적변화，동태관찰대량수혈후대환자응혈공능지표적영향。방법：회고성분석2011년6월～2013년10월대출혈환자32례，남26례，녀6례；년령24～51세，평균37．5세。출혈원인：간파렬5례、비파렬8례、급성상소화도출혈3례、중도손상（다발골절）14례、산후대출혈2례。수혈량위2000～4500 ml，평균2800 ml。분별검측기수혈전급수혈후제1、3、7천적응혈4항지표，대수혈전여수혈후검측지표진행통계학비교。결과：대량수혈후제1천여수혈전비교 PT、APTT、TT시간유현저연장（ P＜0．05）， FIB현저강저（P＜0．05）；수혈후제3천여수혈후제1천비교， PT、APTT、TT시간유현저축단（P＜0．05）， FIB칙현저증고（P＜0．05）；수혈후제7천여수혈전비교 PT、APTT、TT、FIB무현저성차이（P＞0．05）。결론：외과환자진행대량수혈치료시，응진행응혈4항지표적동태검측，위림상수혈치료제공유력적실험진단의거，선택괄합적성분수혈，피면발생응혈공능장애인기불필요적출혈。
Objective:To investigate the surgical patients with a large number of different time after blood transfusion blood coagula-tion the change of the four indicators, dynamic observation of a lot of influence on blood coagulation function in patients with index after blood transfusion.Methods:A retrospective analysis in June 2011 to October 2013, 32 cases of hemorrhage patients, 6 cases of male 2, female 6 cases;Age 24~51 years old, average 37.5 years.Bleeding reason:liver rupture in 5 cases, splenic rupture 8 cases, 3 cases of acute upper gastrointestinal bleeding, severe injury (multiple fractures), 14 cases, 2 cases of postpartum hemorrhage.Blood transfu-sion amount is 2000~4500 ml, an average of 2800 ml.The blood transfusion before and after blood transfusion was detected in 1, 3, 7 d coagulation four indicators, detection of before and after blood transfusion blood transfusions indicators statistical comparison .Re-sults:A large number of 1 d after blood transfusion and transfusion before comparing significantly prolong PT , APTT, TT time ( P <0 . 05), FIB significantly reduced (P <0.05);3 d after blood transfusion compared with 1 d after blood transfusion, PT, APTT, TT time significantly shortened (P <0.05) and FIB were significantly increased (P <0.05);7 d after blood transfusion and transfusion comparison PT, APTT, TT, FIB before there was no significant difference (P >0.05).Conclusion:Surgical patients, a large number of blood transfusion treatment should be dynamic detection of coagulation four indicators , provides the powerful experimental diagnosis basis for the clinical blood transfusion treatment, choose suitable composition blood transfusion, avoid cause unnecessary bleeding blood coagulation dysfunction.