CAJ | 학술논문

目的：探讨等比例成分输血在严重多发伤合并创伤性凝血病（ACT）中的临床疗效。方法选取2009年3月31日至2013年3月31日重症医学科收治严重多发伤合并创伤性凝血病（ACT）患者38例，分为对照组和试验组，对照组不按比例输注悬浮红细胞（PRBC）和新鲜冰冻血浆（FFP），试验组按1∶1比例输注。检测患者入院后1、2、3d血红蛋白（HB）、凝血酶原时间（PT）、国际化标准比率（INR）、纤维蛋白原（FIB）水平。统计入院3dPRBC的总量、休克纠正率、ICU住院时间、28d病死率。结果试验组入院后第2天、第3天PT、INR、FIB优于对照组（P＜0．05）。试验组3dPRBC用量少于对照组[（18．5±6．3）Uvs．（25．9±7．8）U]；ICU住院时间少于对照组[（5．9±4．3）dvs．（10．5±7．6）d]；休克纠正率高于对照组（85．0％vs．44．4％）；28d病死率低于对照组（10．0％vs．27．8％）（P＜0．05）。结论等比例成分输血改善严重多发伤合并ACT患者的凝血指标，可减少ICU期间输注红细胞的总量，提高休克纠正率、减少ICU住院时间及28d病死率。
목적：탐토등비례성분수혈재엄중다발상합병창상성응혈병（ACT）중적림상료효。방법선취2009년3월31일지2013년3월31일중증의학과수치엄중다발상합병창상성응혈병（ACT）환자38례，분위대조조화시험조，대조조불안비례수주현부홍세포（PRBC）화신선빙동혈장（FFP），시험조안1∶1비례수주。검측환자입원후1、2、3d혈홍단백（HB）、응혈매원시간（PT）、국제화표준비솔（INR）、섬유단백원（FIB）수평。통계입원3dPRBC적총량、휴극규정솔、ICU주원시간、28d병사솔。결과시험조입원후제2천、제3천PT、INR、FIB우우대조조（P＜0．05）。시험조3dPRBC용량소우대조조[（18．5±6．3）Uvs．（25．9±7．8）U]；ICU주원시간소우대조조[（5．9±4．3）dvs．（10．5±7．6）d]；휴극규정솔고우대조조（85．0％vs．44．4％）；28d병사솔저우대조조（10．0％vs．27．8％）（P＜0．05）。결론등비례성분수혈개선엄중다발상합병ACT환자적응혈지표，가감소ICU기간수주홍세포적총량，제고휴극규정솔、감소ICU주원시간급28d병사솔。
Objective To investigate the clinical effect of the blood transfusion with equal ratio component in severe multiple in‐juries with acute traumatic coagulopathy(ATC) .Methods Thirty‐eight patients who had severe multiple injuries with ATC were divided randomly into control group and treatment group .Control group was treated with the different ratio packed red blood cells (PRBC)and fresh frozen plasma(FFP) ,while treatment group received the equal ratio PRBC and FFP .Hemoglobin(HB) ,pro‐thrombin time(PT) ,international normalized ratio(INR) ,fibrinogen(FIB)were measured on the 1st ,2nd ,3rd day after admission . The total amount of PRBC during these 3 days ,the days of hospitalization in ICU ,the corrected rate of shock ,the 28‐day mortality were compared between groups .Results Compared with the control group ,the levels of PT ,INR and FIB of treatment group on the 2nd ,3rd day after admission were better(P<0 .05) .The total amount of PRBC[(18 .5 ± 6 .3)U]during these 3 days ,the days of hospitalization in ICU [(5 .9 ± 4 .3)d] in treatment group were less than those in the control group [(25 .9 ± 7 .8)U ,(10 .5 ± 7 .6)d] (P<0 .05) ,while the corrected rate of shock(85 .0% )in treatment group was higher than that of the control group(44 .4% ) .The 28‐day mortality(10 .0% )in treatment group was lower than that of the control group(27 .8% )(P<0 .05) .Conclusion The blood transfusion with equal ratio component in severe multiple injuries with ATC could not only improve blood clotting index ,reduce the total amount of PRBC and the time in ICU ,but also increase the corrected rate of shock and decrease the 28‐day mortality .