大量输血后患者血清电解质、凝血功能及酸碱平衡变化情况分析

Analysis of changes of serum electrolyte,coagulation function and acid-base balance in patients after massive blood transfusion

目的 探究大量输血后患者血清电解质、凝血功能及酸碱平衡变化情况。方法 选择2018年12月~2021年1月在院接受大量输血治疗的168例患者作为研究对象,对比分析输血前后电解质(Na^(+)、K^(+)、Ca^(2+)、Cl^(-))、凝血功能(PT、APTT、TT、FIB、PLT)、血气分析(pH值、Lac、BE)、TCO_(2)、肝功能(AST、ALT、TBil)、肾功能(BUN、Cr、UA)变化情况。结果 输血后K^(+)、Ca^(2+)、FIB、PLT、pH值、静脉血TCO_(2)水平低于输血前,PT、APTT、TT、BE、Lac、ALT、AST、TBil高于输血前,差异均有统计学意义(P<0.05);所有患者输血前后Na^(+)、Cl^(-)、BUN、Cr、UA比较,差异无统计学意义(P>0.05)。结论 大量输血后会对机体电解质水平、凝血功能、酸碱指标产生一定影响,因此对输血患者,应密切监测电解质、凝血功能和血气分析结果。

Objective To explore the variation of the serum electrolytes,coagulation function and acid-base disorder in patients after massive blood transfusion.Methods A total of 168 cases received massive blood transfusion in our hospital from December 2018 to January 2021 were selected as the research object.The serum electrolytes (Na^(+),K^(+),Ca^(2+),Cl^(-)),coagulation function (PT,APTT,TT,FIB,PLT),blood gas analysis (pH,Lac,BE,TCO_(2)),Hepatic function (AST,ALT,TBil),renal function (BUN,Cr and UA) were compared before and after blood transfusion.Results The level of K^(+),Ca^(2+),FIB,PLT,pH value,TCO_(2) of venous blood after blood transfusion were lower than those of before blood transfusion.The PT,APTT,TT,BE,Lac,ALT,AST,TBil were higher than that of before blood transfusion.The differences were statistically significant before and after blood transfusion (P<0.05).The level of Na+,Cl-,BUN,Cr and UA of before and after blood transfusion were not statistically significant (P>0.05).Conclusion To some extent,massive blood transfusion can affect the level of serum electrolytes,coagulation function and the indictors of acid-base.It is necessary to closely supervise the serum electrolytes,coagulation function and the results of blood gas analysis,which has important clinical meaning.