血浆输注对肝癌患者凝血功能和肝生化指标的影响

Effects of plasma transfusion on blood coagulation and liver function in patients with hepatic carcinoma

目的观察肝癌患者输注血浆前后凝血和肝生化指标的变化，为临床提供合理的输血和疗效评价方案。方法收集原发性肝癌住院患者病历资料，筛选出输注血浆治疗的140例患者，按照输血前凝血指标是否异常分为高凝血指标组44例和低凝血指标组96例，每例输血次数为1～2次，每次200～300ml，输血时间为上午9：00，检测时间为输血第2天上午8：00，检测凝血和肝生化指标。结果高凝血指标组患者血浆输注后凝血功能明显改善，凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）明显下降，差异均有统计学意义（P〈0.05或0．01），同时患者血浆输注后肝生化指标丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）明显下降，白蛋白（AIb）水平上升，差异均有统计学意义（P〈0.05或0．01）。低凝血指标组患者血浆输注前后，凝血和肝生化指标差异均无统计学意义（均P〉0．05）。结论原发性肝癌患者血浆输注后凝血和肝生化指标得到改善，综合判断和评价血浆输注疗效需同时考虑凝血和肝生化指标。

Objective To assess the effects of plasma transfusion on blood coagulation and liver function in patients with hepatic carcinoma. Methods The clinical data of 140 patients with primary hepatic carcinoma receiving plasma transfusion were retrospectively reviewed, including 44 cases with high coagulation status and 96 cases with low coagulation status before plasma transfusion. Each time, 200-300ml plasma was transfused at the morning and each patient received 1-2 time of transfusion, the blood coagulation and liver function indexes were examined at the morning of following day. Results The blood coagulation function in high coagulation group was significantly improved after plasma transfusion, PT and APTT decreased significantly （P〈 0.05 or 〈0.01）; the liver biochemical indexes were also significantly improved, ALT and AST decreased significantly, AIb increased significantly （P〈0.05 or 〈0.01）. However, there were no significant differences in blood coagulation and liver function indexes of low coagulation group after plasma transfusion （P 〉0.05）. Conclusion Plasma transfusion can improve blood coagulation and liver function in primary hepatic carcinoma patients with high coagulation status.