不同冰冻血浆与红细胞比例输血方案治疗创伤失血性休克患者的效果

Effects of different frozen plasma and red blood cell ratio transfusion regimens in treatment of patients with traumatic hemorrhagic shock

目的:观察不同冰冻血浆与红细胞比例输血方案治疗创伤失血性休克患者的效果。方法:回顾性分析2020年8月至2022年8月该院收治的96例创伤失血性休克患者的临床资料,按照输血方案不同将其分为研究组和对照组各48例。对照组采用冰冻血浆∶红细胞为1∶2输血方案治疗,研究组采用冰冻血浆∶红细胞为1∶1输血方案治疗。比较两组住院时间、重症监护室(ICU)入住时间,输血前后血栓弹力图(TEG)参数[血凝块最大强度(MA)、凝血因子反应时间(R)、血细胞凝集块形成速率(α角)、血细胞凝集块形成时间(K)]水平、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)]水平和预后情况。结果:研究组住院时间、ICU入住时间均短于对照组,差异有统计学意义(P<0.05);输血后24 h,研究组R、MA、K、α角等TEG参数水平均高于对照组,差异有统计学意义(P<0.05);研究组APTT、PT、TT水平均高于对照组,FIB水平均低于对照组,差异有统计学意义(P<0.05);输血后7 d,研究组预后良好率为72.92%(35/48),高于对照组的52.08%(25/48),差异有统计学意义(P<0.05)。结论:冰冻血浆∶红细胞为1∶1输血方案治疗创伤失血性休克患者可缩短住院时间和ICU入住时间,改善凝血功能指标水平,提高TEG参数水平和预后良好率,效果优于冰冻血浆∶红细胞为1∶2输血方案治疗。

Objective:To observe effects of different frozen plasma and red blood cell ratio transfusion regimens in treatment of patients with traumatic hemorrhagic shock.Methods:The clinical data of 96 patients with traumatic hemorrhagic shock admitted to this hospital from August 2020 to August 2022 were retrospectively analyzed.According to different blood transfusion regimens,they were divided into study group and control group,48 cases in each group.The control group was treated with frozen plasma:red blood cells of 1:2 blood transfusion regimen,while the study group was treated with frozen plasma:red blood cells of 1:1 blood transfusion regimen.The hospitalization time,the intensive care unit(ICU)stay time,the thrombelastogram(TEG)parameter levels before and after blood transfusion[maximum amplitude of clot(MA),coagulation factor reaction time(R),blood cell clot formation rate(αangle),blood cell clot formation time(K)],the coagulation function index levels[partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)].and the prognosis were compared between the two groups.Results:The hospitalization time and the ICU stay time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).24 h after blood transfusion,the levels of TEG parameters such as R,MA,K andαangle in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of APTT,PT and TT in the study group were higher than those in the control group,the levels of FIB were lower than those in the control group,and the differences were statistically significant(P<0.05).7 days after blood transfusion,the good prognosis rate of the study group was 72.92%(35/48),which was higher than 52.08%(25/48)of the control group,and the difference was statistically significant(P<0.05).Conclusions:The transfusion regimen of frozen plasma:red blood cells of 1:1 in the treatment of the patients with traumatic hemorrhagic shock can shorten the hospitalization time and the ICU stay time,improve the levels of coagulation function indexes,and improve the levels of TEG parameters and the good prognosis rate.Moreover,it is superior to the transfusion regimen of frozen plasma:red blood cell of 1:2.