以1∶1比例输注新鲜冰冻血浆和去白悬浮红细胞对严重创伤急诊患者的影响

Effect of 1:1 infusion of fresh frozen plasma and leukocyte-removed suspended red blood cells on emergency patients with severe trauma

目的探讨以1∶1的比例输注新鲜冰冻血浆和去白悬浮红细胞对严重创伤急诊患者血栓弹力图指标和预后转归的影响。方法选取收治的120例严重创伤行急诊输血患者,将其按照输注新鲜冰冻血浆和去白悬浮红细胞比例的不同分为1∶1比例输注治疗组、1∶2比例输注治疗组、1∶3比例输注治疗组,每组均40例。输注后,比较三组血栓弹力图指标[凝固角(α-Angle)、输血后凝固时间(K)值、反应时间(R)值以及血栓最大幅度(MA)值],并记录术后24 h出血量、重症监护病房(ICU)住院时间、休克纠正时间以及血容量恢复时间。结果输注后,1∶1比例输注治疗组的α-Angle、MA值高于1∶2、1∶3比例输注治疗组,K值、R值较1∶2、1∶3比例输注治疗组低(P<0.05);1∶1比例输注治疗组的ICU住院时间、休克纠正时间以及血容量恢复时间均较1∶2、1∶3比例输注治疗组短(P<0.05)。结论为严重创伤急诊患者以1∶1的比例输注新鲜冰冻血浆和去白悬浮红细胞可有效改善其凝血状态,并为其预后的改善提供积极助力,其应用效果值得肯定。

Objective To investigate the effect of 1∶1 infusion of fresh frozen plasma and leukocyte-removed suspended red blood cells on the indexes of thromboelastogram and prognosis of severe trauma emergency patients.Methods A total of 120 patients with severe trauma undergoing emergency blood transfusion were prospectively collected and divided into 1∶1 proportional infusion treatment group,1∶2 proportional infusion treatment group,and 1∶3 proportional infusion treatment group according to different proportions of fresh frozen plasma infusion and leukocyte-removed suspended red blood cell infusion,40 patients in each group.After infusion,comparisons were made among the three groups of thromboelastogram indexes[coagulation angle(α-Angle),coagulation time(K)after blood transfusion,reaction time(R),and maximum thrombus amplitude(MA)],as well as recording of the amount of bleeding 24 h after operation,the length of stay in intensive care unit(ICU),the time to correct shock,and the time to recover blood volume.Results After infusion,theα-Angle and MA of the 1∶1 proportional infusion treatment group were higher than those of the 1∶2 and 1∶3 proportional infusion treatment groups,while the values of K and R were lower(P<0.05).The ICU hospitalization time,shock correction time,and blood volume recovery time of the 1∶1 proportional infusion treatment group were shorter than those of the 1∶2 and 1∶3 proportional infusion treatment groups(P<0.05).Conclusion Infusion of fresh frozen plasma and leukocyte-removed suspended red blood cells at a ratio of 1∶1 for emergency patients with severe trauma can effectively improve their coagulation state and provide positive assistance for their prognosis,and its application effect is worthy of affirmation.