严重创伤救治中全血输注进展

Progress of whole blood transfusion for severe trauma care

近年来,严重创伤造成的死亡率显著上升,出血和失血性休克作为创伤早期可纠正的致死原因,输血是其重要的救治措施。全血输注是最早的输血方法,但随着对血液需求的增加,以及人们逐渐认识到全血输注在一定程度上存在疾病传播、疗效差等不良反应的风险,成分输血逐渐成为主要的输血方式。然而,在伊拉克战争和阿富汗战争中,全血输注因有效性突出而备受关注,进一步使全血输注再次成为严重创伤救治研究的热点。笔者主要综述严重创伤救治中全血输注的法规依据、指征和安全性、保障和流程,以及战时战伤救治、平时创伤救治中全血输注的效果等,以期指导临床严重创伤救治。

In recent years,the mortality caused by severe trauma has increased significantly.Bleeding and hemorrhagic shock are correctable causes of early preventable death in trauma cases.Blood transfusion is a critical intervention.Whole blood transfusion is the earliest blood transfusion method,but with the increasing demand for blood and the gradual recognition of the risks of disease transmission and poor therapeutic effects associated with whole blood transfusion,component blood transfusion has gradually become the main blood transfusion method.However,the whole blood transfusion in Iraq War and Afghanistan war has attracted much attention because of its effectiveness,making whole blood transfusion once again a hot spot in the treatment of severe trauma.In order to guide the treatment of severe trauma,this paper reviews the legal basis,indication and safety,guarantee and process of whole blood transfusion in the treatment of severe trauma,and the effect of whole blood transfusion in the treatment of war injury and civilian trauma.