严重创伤患者紧急救治血液保障模式与输血策略中国专家共识(2024版)

Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients(version 2024)

严重创伤患者对救治时效性要求极高,输血在此类患者的紧急救治阶段发挥着不可替代的作用。越来越多的循证医学证据和临床经验表明,早期输注低效价O型全血或平衡比例红细胞、血浆和血小板等成分血的止血复苏策略将使严重创伤大出血患者获益。然而,当前国内血液保障模式不能完全满足临床对严重创伤患者紧急救治输血的时效性和有效性需求。针对我国严重创伤紧急救治血液保障模式与输血策略中存在的关键问题,中华医学会临床输血学分会、中华医学会创伤学分会创伤急救与多发伤学组和中华医学会灾难医学分会青年学组组织国内输血医学和创伤救治专家,基于循证医学证据并结合Delphi法专家咨询投票,共同制订《严重创伤患者紧急救治血液保障模式与输血策略中国专家共识(2024版)》,从血液保障模式和输血策略两个方面共提出10条推荐意见,为严重创伤紧急救治阶段的输血复苏提供参考,以期进一步提高严重创伤患者的救治成功率。

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients.An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells,plasma and platelet of a balanced ratio.However,the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice.In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma,Branch of Clinical Transfusion Medicine of Chinese Medical Association,Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association,Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients(version 2024).Based on the evidence-based medical evidence and Delphi method of expert consultation and voting,10 recommendations were put forward from two aspects of blood support mode and transfusion strategies,aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.