重症监护室患者输注血浆前后PT和APTT值的变化及疗效分析

Changes of PT and APTT values of patients in ICU before and after plasma transfusion

目的:分析重症监护患者输注血浆前后凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)变化情况,旨在更好的指导临床科学合理使用血浆。方法:选择2017-03-2018-03内科重症监护室130例患者(血浆置换患者除外)作为研究对象,回顾性分析130例患者共181人次输注前后凝血结果PT和APTT变化情况与血浆输注次数的关系。结果:130例患者,共181人次血浆输注后,其PT(120例),APTT(106例)明显降低,降低者分别占66.3%,58.5%,说明血浆输注有效。30%的患者输注前后凝血检查结果无变化或者升高;血浆输注后PT和APTT同时降低的概率在分组中占大多数(91人次),特别输注量在600~800 mL,PT和APTT同时降低的概率在其相应的分组中最多。结论:按规范和要求进行血浆输注,对于凝血功能紊乱患者,输注后大部分PT和APTT明显降低,凝血功能紊乱得到有效改善。血浆输注的主要目的是为患者补充凝血因子,不合理输注反而会增加患者用血风险,输血治疗对于重症患者病情改善是有效的手段之一,需要进一步提高输注的有效性和安全性。

Objective:To analyze the changes of PT and APTT values of patients in ICU before and after plasma transfusion in order to better guide clinical scientific and rational use of plasma.Method:From March 2017 to March 2018,130 patients(except those with plasma exchange)in the intensive care unit(ICU)of our hospital were selected as the study subjects.The relationship between PT and APTT values of coagulation results and the number of plasma transfusion was retrospectively analyzed before and after 181 times of transfusion in 130 patients.Result:After 181 plasma transfusions,PT(120 cases)and APTT(106 cases)decreased significantly by 66.3%and 58.5%respectively,indicating that plasma transfusion was effective,and coagulation test results did not change or increase in about 30%of patients before and after plasma transfusion.The probability of PT and APTT decreasing simultaneously after plasma transfusion was the majority in the group(91/181),but the difference was not significant.When the infusion volume was between 600 and 800 mL,the probability of PT and APTT decreasing simultaneously was the most in the corresponding grouping.Conclusion:For the patients with coagulation disorder,most of the PT and APT are obviously reduced and coagulation disorder is effectively improved.The blood coagulation factor is mainly supplemented by plasma transfusion.Irrational transfusion would increase the risk of blood use.Blood transfusion therapy is one of the effective means to improve the condition of severe patients,and it is needed to further improve the effectiveness and safety of blood transfusion.