联合输注单采血小板和冷沉淀凝血因子在急性大失血患者中的治疗作用

Therapeutic effects of co-infusion of apheresis platelets and cryoagglutinin in treatment of patients with acute massive blood loss

目的:研究急诊联合输注单采血小板和冷沉淀在治疗急性大失血患者患者中的疗效。方法:急性大失血患者随机分为3组:单采血小板与冷沉淀凝血因子联合输注组(共43例),单采血小板单独输注组(共13例)和冷沉淀凝血因子单独输注组(共11例)。联合输注组先后输注血小板10U,冷沉淀凝血因子10U;单采血小板单独输注组,给予单采血小板10U;冷沉淀凝血因子单独输注组给予冷沉淀凝血因子10U输注。检测治疗前后血浆凝血酶原时间(PT)、血浆部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)、血小板计数(PLT)。结果:与输注单采血小板组和冷沉淀组相比,联合输注组PT、APTT、TT均显著性缩短(P<0.05或P<0.01),有效止血率明显增高(P<0.01),平均止血时间明显缩短(P<0.01),24h内悬浮红细胞续用量显著减少(P<0.01)。结论:在大量失血患者的治疗中,联合输注血小板及冷沉淀能显著改善凝血功能,促进止血功能,具有更显著的止血效果。

Objective：To investigate the therapeutic effects of co-infusion of apheresis platelets and cryoagglutinin in the treatment of patients with acute massive blood loss at the Department of Emergency Medicine.Method：Patients with acute massive blood loss were randomly divided into three groups：co-infusion group（n=43）,apheresis platelets group（n=13）,and cryoagglutinin group（n=11）.Patients in co-infusion group received infusion of 10U apheresis platelets and 10U cryoagglutinin.Patients in apheresis platelets group received infusion of 10Ua-pheresis platelets.Patients in cryoagglutinin group received infusion of 10Ucryoagglutinin.The prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（Fbg）and platelet count（PLT）were detected before and after the treatment.Result：Compared to the apheresis platelets group and cryoagglutinin group,PT,APTT and TT in co-infusion group were significantly shorter（P0.05 or P0.01）,the effective hemostasis rate was significantly higher（P0.01）,the average bleeding time was significantly shorter（P 0.01）,the consumption of suspended red blood cells in 24h were decreased significantly（P0.01）.Conclusion：The co-infusion of apheresis platelets and cryoagglutinin could significantly improve coagulation function,promote hemostatic function,and has more significant hemostatic effect in the treatment of patients with acute massive blood loss.