不同输血方式对急性大失血患者临床效果及安全性分析

Analysis of clinical effect and safety of different blood transfusion methods in patients with acute massive blood loss

目的比较不同输血方式对急性大失血患者的临床效果及安全性。方法66例急性大失血患者,采取随机数字表法分为研究组与对照组,各33例。对照组给予单采血小板输注治疗,研究组给予血小板联合凝血因子治疗。比较两组患者输血后2 h内有效止血率、平均止血时间、24 h悬浮红细胞连续用量、血常规指标[血细胞比容(HCT)、血红蛋白(HGB)、血小板计数(PLT)]、凝血四项指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、不良反应发生情况。结果研究组患者输血后2 h内有效止血率为93.9%(31/33),高于对照组的60.6%(20/33),差异有统计学意义(P<0.05)。研究组患者平均止血时间短于对照组,24 h悬浮红细胞连续用量少于对照组,差异有统计学意义(P<0.05)。输血后,研究组患者HCT、HGB、PLT均显著高于对照组,差异有统计学意义(P<0.05)。输血后,研究组患者PT、APTT、TT短于对照组,FIB高于对照组,差异有统计学意义(P<0.05)。研究组患者不良反应发生率为6.1%,低于对照组的24.2%,差异有统计学意义(P<0.05)。结论急性大失血患者应用血小板联合凝血因子输血治疗可取得很好的止血效果,且不良反应较少,治疗安全性有保障。

Objective To compare the clinical effect and safety of different blood transfusion methods in patients with acute massive blood loss.Methods A total of 66 patients with acute massive blood loss were divided into research group and control group according to random numerical table,with 33 cases in each group.The control group received apheresis platelet transfusion therapy,and the research group received platelet combined with coagulation factor therapy.The effective hemostatic rate within 2 h of blood transfusion,average hemostatic time,continuous dosage of suspended red blood cells for 24 h,blood routine indexes[hematocrit(HCT),hemoglobin(HGB),platelet count(PLT)],four coagulation indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)],and incidence of adverse reactions were compared between the two groups.Results The effective hemostatic rate within 2 h of blood transfusion of the research group was 93.9%(31/33),which was higher than 60.6%(20/33)of the control group,and the difference was statistically significant(P<0.05).The average hemostatic time of the research group was shorter than that of the control group,and the continuous dosage of suspended red blood cells for 24 h was less than that of the control group,and the difference was statistically significant(P<0.05).After blood transfusion,the HCT,HGB and PLT of the research group were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).After blood transfusion,the PT,APTT and TT of the research group were shorter than those of the control group,and the FIB was higher than that of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions of the research group was 6.1%,which was lower than 24.2%of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of platelet and blood coagulation factor transfusion therapy for patients with acute massive blood loss can achieve good hemostasis effecy,with fewer adverse reactions,and the safety of treatment is guaranteed.