不同比例新鲜冰冻血浆与红细胞输注在产后出血患者中的应用效果比较

Application effects of different proportions of fresh frozen plasma and red blood cell transfusion in patients with postpartum hemorrhage

目的:比较不同比例新鲜冰冻血浆(FFP)与红细胞(RBC)输注在产后出血患者中的应用效果。方法:选取2020年1月至2022年1月该院收治的70例产后出血患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各35例。对照组按FFP∶RBC为1∶2.5比例输血,观察组按FFP∶RBC为1∶1比例输血,比较两组凝血功能指标[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)]水平、血小板(PLT)水平、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8]水平和不良事件发生率。结果:治疗后,观察组PT、APTT、TT短于对照组,FIB、PLT水平高于对照组,差异有统计学意义(P<0.05);治疗后,两组血清TNF-α、IL-6、IL-8水平均高于输血前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组不良事件发生率为20.00%,低于对照组的45.71%,差异有统计学意义(P<0.05)。结论:FFP与RBC按1∶1比例输注用于产后出血患者可改善其凝血功能指标、PLT水平,降低炎性因子水平和不良事件发生率,效果优于按1∶2.5比例输注。

Objective:To observe application effects of different proportions of fresh frozen plasma(FFP)and red blood cell(RBC transfusion in patients with postpartum hemorrhage.Methods:A prospective study was conducted on 70 patients with postpartum hemorrhage admitted to this hospital from January 2020 to January 2022.They were divided into observation group and control group according to the random number table method,35 cases in each.The control group was transfused with FFP:RBC at a ratio of 1:2.5,while the observation group was transfused with FFP:RBC of 1:1.The coagulation function index levels[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)],the platelet(PLT)level,the serum inflammatory factor levels[tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-8],and the incidence of adverse events were compared between the two groups.Results:After the treatment,the levels of PT,APTT and TT in the observation group were shorter than those in the control group,the FIB and PLT levels were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of serum TNF-α,IL-6 and IL-8 in the two groups were higher than those before blood transfusion,but those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse events in the observation group was 20.00%,which was lower than 45.71%in the control group,and the difference was statistically significant(P<0.05).Conclusions:FFP and RBC transfusion at a ratio of 1:1 for the patients with postpartum hemorrhage can improve their coagulation function indexes and PLT levels and reduce the levels of inflammatory factors and the incidence of adverse events.Moreover,it is superior to 1:2.5transfusion.