大量输血后纤维蛋白原和血小板的临床观察

目的 24h内输血量>3500mL后纤维蛋白原(the fibrinogen,FIB)和血小板(the platelet,PLT)的临床观察。方法选择择期手术的患者25例,在24h内输血量>3500ml,监测输血前和输血后纤维蛋白原(FIB)和血小板(PLT)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)。结果 24h内输血量>3500mL后血小板(PLT)和纤维蛋白原(FIB)明显下降(P<0.01),凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)延长(P<0.05)。结论患者大量输血后极易出现稀释性血小板减少,纤维蛋白原溶解,应及时动态监测并解决相应问题,防止严重并发症的发生。

Objective To observe the fibrinogen（FIB）and the platelet（PLT）when the blood transfusion exceeding 3500mL in 24 hours.Methods Chose 25 patients for selecting operation with the blood transfusion is more than 3500mL in 24 hours,monitoring the FIB,PLT,prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）before and after transfusion.Results When the blood transfusion surpass 3500mL in 24 hours,the PLT and the FIB are obviously descending（P〈0.01）.Patients with PLT,PT,APTT,TT extending are extremely（P〈0.05）.Conclusion After multiplicity blood transfusion,the patients will be easy to emerge dilute plate-reduction and fibrinogenolysis.We should dynamically monitor the thrombin function in time and solve the problem to prevent the severity complications.