浙江临床医学
浙江臨床醫學
절강림상의학
ZHEJIANG CLINICAL MEDICAL JOURNAL
2015年
6期
870-871
,共2页
王敬波%胡旭梅%王伟%吴伟
王敬波%鬍旭梅%王偉%吳偉
왕경파%호욱매%왕위%오위
血小板%冷沉淀%联合输注%大量输血%凝血
血小闆%冷沉澱%聯閤輸註%大量輸血%凝血
혈소판%랭침정%연합수주%대량수혈%응혈
Platelets cryoprecipitate%Joint infusion%A large number of blood transfusion%Blood coagulation
目的:了解机采血小板联合冷沉淀输注对大出血患者凝血功能的影响。方法选取2010年1月至2014年9月进行大量输血治疗的急性大出血患者122例,将单独输注机采血小板的患者设为血小板组,单独输注冷沉淀的患者设为冷沉淀组,机采血小板联合输注冷沉淀者设为联合组。观察3组患者输血前后凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、血小板(PLT)等指标的变化情况。结果3组患者输注前凝血功能指标比较,差异无统计学意义(P>0.05)。联合组患者血小板联合冷沉淀输注后,PT、APTT、TT较输注前明显缩短(P<0.05),FIB、PLT较输注前明显增加,差异有统计学意义(P<0.05);联合组与机采血小板输注组比较,PT、APTT、TT明显缩短,FIB明显增加,差异有统计学意义(P<0.05),与冷沉淀组比较,PT、APTT、TT明显缩短,PLT明显增加,差异有统计学意义(P<0.05)。结论机采血小板联合冷沉淀输注可显著提高大量输血患者血液循环中凝血物质的含量,缩短凝血时间,可更好的避免凝血功能紊乱。与单独输注机采血小板或冷沉淀相比,具有更显著的止血效果。
目的:瞭解機採血小闆聯閤冷沉澱輸註對大齣血患者凝血功能的影響。方法選取2010年1月至2014年9月進行大量輸血治療的急性大齣血患者122例,將單獨輸註機採血小闆的患者設為血小闆組,單獨輸註冷沉澱的患者設為冷沉澱組,機採血小闆聯閤輸註冷沉澱者設為聯閤組。觀察3組患者輸血前後凝血酶原時間(PT)、活化部分凝血酶原時間(APTT)、凝血酶時間(TT)、纖維蛋白原(FIB)、血小闆(PLT)等指標的變化情況。結果3組患者輸註前凝血功能指標比較,差異無統計學意義(P>0.05)。聯閤組患者血小闆聯閤冷沉澱輸註後,PT、APTT、TT較輸註前明顯縮短(P<0.05),FIB、PLT較輸註前明顯增加,差異有統計學意義(P<0.05);聯閤組與機採血小闆輸註組比較,PT、APTT、TT明顯縮短,FIB明顯增加,差異有統計學意義(P<0.05),與冷沉澱組比較,PT、APTT、TT明顯縮短,PLT明顯增加,差異有統計學意義(P<0.05)。結論機採血小闆聯閤冷沉澱輸註可顯著提高大量輸血患者血液循環中凝血物質的含量,縮短凝血時間,可更好的避免凝血功能紊亂。與單獨輸註機採血小闆或冷沉澱相比,具有更顯著的止血效果。
목적:료해궤채혈소판연합랭침정수주대대출혈환자응혈공능적영향。방법선취2010년1월지2014년9월진행대량수혈치료적급성대출혈환자122례,장단독수주궤채혈소판적환자설위혈소판조,단독수주랭침정적환자설위랭침정조,궤채혈소판연합수주랭침정자설위연합조。관찰3조환자수혈전후응혈매원시간(PT)、활화부분응혈매원시간(APTT)、응혈매시간(TT)、섬유단백원(FIB)、혈소판(PLT)등지표적변화정황。결과3조환자수주전응혈공능지표비교,차이무통계학의의(P>0.05)。연합조환자혈소판연합랭침정수주후,PT、APTT、TT교수주전명현축단(P<0.05),FIB、PLT교수주전명현증가,차이유통계학의의(P<0.05);연합조여궤채혈소판수주조비교,PT、APTT、TT명현축단,FIB명현증가,차이유통계학의의(P<0.05),여랭침정조비교,PT、APTT、TT명현축단,PLT명현증가,차이유통계학의의(P<0.05)。결론궤채혈소판연합랭침정수주가현저제고대량수혈환자혈액순배중응혈물질적함량,축단응혈시간,가경호적피면응혈공능문란。여단독수주궤채혈소판혹랭침정상비,구유경현저적지혈효과。
Objective To understand the impacts of joint infusion of apheresis platelet and cryoprecipitate on blood coagulation function in patients with massive blood transfusion. Methods 122 cases of acute bleeding patients for massive blood transfusion were choosed as the research object in our hospital between January 2010 and September 2014. The patients with only infusion of apheresis platelet were set as the platelet group,only infusion of cryoprecipitate as the cryoprecipitate group,and joint infusion of apheresis platelet and cryoprecipitate as the joint group. Prothrombin time(PT),Activated partial prothrombin time(APTT),Thrombin time(TT),Fibrinogen(FIB)and platelet(PLT)before and after blood transfusion were observed in three groups. Results Blood clotting indexes before blood transfusion were compared in three groups,there were no statistically significant difference(P>0.05). PT,TT and APTT after joint infusion were significantly shortener than those before infusion in the joint group(P<0.05).FIB and PLT were significantly increased after the infusion in the joint group(P<0.05). PT,APTT and TT were shortened obviously,FIB increased significantly in the joint group,and were compared with those in the platelet group,the difference were statistically significant(P<0.05),compared with cryoprecipitate group,PT,APTT, TT shortened obviously,PLT increased significantly,the difference were statistically significant(P<0.05). Conclusion Joint infusion of apheresis platelet and cryoprecipitate could raise coagulation material content among the blood circulation in patients with massive blood transfusion and shorten the clotting time, to avoid blood coagulation disorder with a more significant hemostatic effect.