冰冻血浆在ICU脓毒症中的疗效分析

Efficacy analysis of frozen plasma in ICU sepsis

目的探索冰冻血浆在脓毒症治疗中的作用及临床价值,以期为脓毒症的治疗提供参考。方法回顾性分析2019年1月至2021年12月入住该院重症监护病房(ICU)226例脓毒症患者的临床资料。根据入住ICU期间是否输注冰冻血浆将患者分为未输注血浆组、输注血浆组,比较两组患者的性别、年龄、入住ICU时降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)、血小板计数(PLT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)检测结果及24 h内序贯器官衰竭评分(SOFA评分),以及ICU住院时间、机械通气时间和疾病的预后。结果输注血浆组的SOFA评分、APTT、PT、有凝血障碍比例较未输注血浆组高,差异有统计学意义(P<0.05)。未输注血浆组与输注血浆组病死率比较,差异无统计学意义(P>0.05)。SOFA评分2~<6、6~<10分生存患者中,输注血浆组的ICU住院时间及机械通气时间均比未输注血浆组短,差异有统计学意义(P<0.05)。SOFA评分2~<6分生存患者中ICU住院时间、机械通气时间从高到低依次为对照组、清蛋白、血浆组、清蛋白组+血浆组;SOFA评分6~<10分生存患者中ICU住院时间、机械通气时间从高到低依次为对照组、清蛋白组、血浆组、清蛋白+血浆组。结论输注血浆在改善脓毒症病死率方面无明显优势,但可以缩短SOFA评分为2~<10分脓毒症患者的病程。

Objective To explore the role and clinical value of frozen plasma in the treatment of sepsis,in order to provide reference for the treatment of sepsis.Methods The clinical data of 226 patients with sepsis admitted to the intensive care unit(ICU)of Suining Center Hospital from January 2019 to December 2021 were analyzed retrospectively.The patients were divided into non-plasma transfusion group and plasma transfusion group according to whether frozen plasma was transfused during ICU stay.The gender,age,and procalcitonin(PCT),C-reactive protein(CRP),white blood cell count(WBC),platelet count(PLT),activated partial thromboplastin time(APTT),prothrombin time(PT),sequential organ failure assessment(SOFA)score during 24 h after entering ICU,length of ICU stay,duration of mechanical ventilation and prognosis of the disease between the two groups were analyzed.Results The SOFA score,APTT,PT in the plasma transfusion group were higher than those in the non-plasma transfusion group,and there were more patients with coagulation disorders in the plasma transfusion group,the differences were statistically significant(P<0.05).There was no significant difference on mortality between the non-plasma transfusion group and the plasma transfusion group(P>0.05).In the survival cases with SOFA scores of 2-<6 and 6-<10,the length of ICU stay and mechanical ventilation in the plasma transfusion group were shorter than those in the non-plasma transfusion group,the differences were statistically significant(P<0.05).In the survival cases with SOFA score of 2—<6,the length of ICU stay and mechanical ventilation from high to low were control group,albumin group,plasma group and plasma group+albumin group.In the survival cases with SOFA score 6—<10,the length of ICU stay and mechanical ventilation time from high to low were the control group,albumin group,plasma group,albumin+plasma group.Conclusion Plasma infusion has no obvious advantage on improving the mortality rate of sepsis,but could shorten the course of sepsis in patients with SOFA score of 2-<10.