自体输血在颅脑创伤治疗中的应用研究

Application of autotransfusion in treatment of craniocerebral trauma

目的 探讨自体输血在颅脑创伤治疗中的应用,并探讨对其凝血机制产生的影响。方法 选取2018年10月—2019年11月南阳市中心医院收治的70例颅脑创伤患者,按照不同的治疗方案将参与研究的人员分为两组,对照组在此次中进行异体血液输注治疗,观察组在此次研究接受自体输血,比较两组恢复良好率、凝血功能凝血功能,包括凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶原时间国际标准化比值(PT-INR)以及活化部分凝血活酶时间(APTT)、并发症发生率及随访2年的生存情况。结果 观察组6个月和1年内生存率为100.00%和97.14%,与对照组的97.14%和91.43%比较差异无统计学意义,P>0.05,观察组2年生存率为94.29%,高于对照组(80.00%),差异有统计学意义(P<0.05);入院时观察组PT、FIB、TT及APTT分别为(14.12±1.78)s、(2.55±0.51)g/L、(18.28±2.26)s及(34.22±4.70)s,与对照组的(13.45±1.52)s、(2.46±0.50)g/L、(18.16±2.25)s及(34.24±4.83)s比较无统计学意义(P>0.05),出院时观察组以上指标分别为(15.78±2.63)s、(4.42±1.47)g/L、(17.33±2.65)s及(38.37±6.15)s,对照组为(15.69±2.57)s、(4.38±1.36)g/L、(17.11±2.22)s及(38.46±6.89)s,均高于入院时,但无统计学意义(P>0.05),两组出院时各指标比较无统计学意义(P>0.05);观察组并发症发生率为22.86%(8/35),低于对照组的45.71%(16/35),差异有统计学意义(P<0.05)。结论 自体输血对颅脑创伤的治疗有积极作用,不影响患者凝血功能,能提高生存率,降低并发症的发生率。

Objective To explore the application of autologous blood transfusion in the treatment of craniocerebral trauma and its influence on the coagulation mechanism.Methods Totally 70 cases of patients with craniocerebral trauma admitted to our hospital from October 2018 to November 2019 were selected.According to different treatment regiments, the participants in the study were divided into 2 groups.The control group received allogeneic blood transfusion during this study, and the observation group received autologous blood transfusion during this study.Prothrombin time(PT),fibrinogen(FIB),international standardized ratio of prothrombin time(PT-INR) and activated partial thrombin time(APTT),complication rate and 2-year follow-up survival were included.Results The 6-month and 1-year survival rate of the observation group was 100.00% and 97.14%,and the difference was not statistically significant compared with 97.14% and 91.43% of the control group(P>0.05).The 2-year survival rate of the observation group was 94.29%,which was higher than that of the control group(80.00%),and the difference was statistically significant(P<0.05).PT,FIB,TT and APTT in observation group were(14.12±1.78) s,(2.55±0.51) g/L,(18.28±2.26) s and(34.22±4.70) s, respectively.Compared with the control group(13.45±1.52) s,(2.46±0.50) g/L,(18.16±2.25) s and(34.24±4.83) s, there was no statistical significance(P>0.05).At discharge, the above indexes in the observation group were(15.78±2.63) s,(4.42±1.47) g/L,(17.33±2.65) s and(38.37±6.15) s, respectively.In the control group, the values were(15.69±2.57) s,(4.38±1.36) g/L,(17.11±2.22) s and(38.46±6.89) s, which were higher than those at admission, but the differences were not statistically significant(P>0.05).There were no statistically significant differences between the two groups when out of the hospital(P>0.05).The incidence of complications in the observation group was 22.86%(8/35),lower than 45.71%(16/35) in the control group, and the difference was statistically significant(P<0.05).Conclusion Autotransfusion has a positive effect on the treatment of craniocerebral trauma, without affecting the coagulation function of patients, can improve the survival rate and reduce the incidence of complications.