胸腔内注入冷沉淀预防复发性气胸的研究

目的：探讨胸膜腔内注入冷沉淀能否降低自发性气胸的同侧复发率。方法：３年间采用随机法将６６例自发性气胸分为粘连组３４例，给予冷沉淀２Ｕ（４０ｍｌ）胸膜腔注入；对照组３２例，单纯行胸腔闭式引流治疗。于第３年随访，对其症状、体征、胸部Ｘ线及肺功能检查，平均随访期（２３．６±９．１）月。结果：胸膜腔内注入冷沉淀无明显不良反应，胸部Ｘ线检查未提示胸膜增厚，各组１０例特发性气胸（随访在１年以上）的肺功能检查比较无明显差异（Ｐ＞０．０５）；粘连组与对照组的复发率分别为６．９％（２／２９）和３７％（１０／２７），有显著性差异（Ｐ＜０．０５）。结论：胸膜腔内注入冷沉淀能有效地降低同侧气胸的复发率，且不会导致限制性肺功能障碍。既适用于特发性、初发性气胸，也适用于继发性、复发性气胸，对于难治性气胸和年老体弱、肺功能差者也可作为一种选择性治疗     

Fibrinogen in traumatic haemorrhage: A narrative review

Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes. Hence, it has been postulated that early fibrinogen replacement in severe traumatic haemorrhage may improve outcomes, although, to date there is a paucity of high quality evidence to support this hypothesis. In addition there is controversy regarding the optimal method for fibrinogen supplementation. We review the current evidence regarding the role of fibrinogen in trauma, the rationale behind fibrinogen supplementation and discuss current research.     

产后出血患者血液管理专家共识（2022年版）

产后出血(PPH)是产科的危重症,需要通过患者血液管理(PBM)改善预后。中国输血协会临床输血学专业委员会制订了PPH的PBM专家共识(2022年版)。该共识强调PBM一定要基于PPH正确处理的基础上。该共识重视血小板和凝血因子的功能和数量的管理,明确了多种情况下血小板和新鲜冰冻血浆等的输注指征。该共识还明确提出了实施大量输血程序的办法。     

Afibrinogenemia Diagnosed During Pregnancy Successfully Managed with Targeted Cryoprecipitate Transfusion: A Case Report

BackgroundWe report a case of afibrinogenemia in a lady, which was detected for the first time during her pregnancy.CaseA 24-year-old G4A3 was referred as a case of vaginal bleeding, after a cervical cerclage at 14 weeks of gestation. Elastometry targeted correction of coagulopathy was done initially, and targeted cryoprecipitate transfusion was done to maintain her gestation. She underwent induced vaginal delivery at 34 weeks of gestation. Fourteen days postpartum, the mother and child were discharged home well.ConclusionCoagulation factor deficiency should be considered as a rare cause for RPL. Serum fibrinogen level of 50–100 mg/dl during pregnancy seems to be a safe and adequate target to maintain in pregnant patients with afibrinogenemia.     

新鲜冰冻血浆和血浆冷沉淀的临床运用

输血现代化的重要标志之一是成分输血,成分输血以其针对性强、制品浓度高．疗效好,方便安全．不良反应少、综合利用、节约血源等特点成为当前输血技术发展的总趋势。随着成分输血的广泛应用,新鲜冰冻血浆和血浆冷沉淀的临床应用日益显现出它的重要。现将它们的临床应用作一分析。     

冷沉淀对改善肿瘤患者凝血功能异常效果分析

目的通过冷沉淀在凝血功能异常的肿瘤患者中的输注,了解不同次数和不同剂量对肿瘤患者凝血常规异常的纠正效果。方法 对15例肿瘤患者在第一次凝血常规结果明显异常时,给予冷沉淀治疗,连续1~5 d,每天都监测血小板及凝血功能的各项指标。结果15例肿瘤患者在冷沉淀给予过程中,凝血常规指标除PLT外,其它指标随着剂量和次数的变化,差异有统计学意义。结论肿瘤患者在凝血常规明显异常时合理使用冷沉淀可以改善其凝血障碍,还可以减少血浆的输注量。但补充冷沉淀的次数及剂量要根据凝血常规的结果再结合患者的病情来具体定夺。     

冷沉淀外用肛周脓肿病人术后创面初报

目的　观察冷沉淀对肛周脓肿病人术后创面愈合的作用。方法　 2 3例病人随机分为实验组和对照组。实验组术后创口外用冷沉淀 ,对照组术后常规处理 ;比较两组创面愈合的时间和效果。结果　实验组创口愈合时间比对照组平均缩短 5 6 8d(P <0 0 1) ,且创面无感染 ,肉芽组织生长良好 ,愈合后疤痕小且柔软度好。结论　血浆冷沉淀具有明显的促进肛周脓肿病人术后创面愈合的作用。     

冷沉淀在患者大量输血后伴有凝血异常中的应用

目的观察患者大量输血后伴有凝血异常时输注冷沉淀的作用。方法对14例严重损伤大量输血后有凝血异常的患者,行输冷沉淀前、输冷沉淀后8～24h和输后3～5d凝血象水平测定、D-二聚体测定。结果患者的凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT)均明显缩短,纤维蛋白原(Fbg)含量增加,14例患者的D-二聚体转为阴性。结论对大量输血后并发凝血异常的患者及时输注冷沉淀,可提高血循环中凝血因子及纤维蛋白原等凝血物质的含量,缩短凝血时间,纠正凝血异常。