血浆与红细胞不同比例输注对大量输血患者凝血功能的影响

目的探讨大量输血时，输注不同比例的血浆和红细胞对大量输‘血患者凝血功能的影响。方法回顾性分析97例大量输血患者临床资料，按入院24h内输注新鲜冰冻血浆（FFP）与浓缩红细胞（CRBC）的比例，以100mI。：1U为比例单位，将患者分为低比例组（FFP：CRBC：1：3，n=20）、中比例组（FFP：CRBC=1：2，n=33）和高比例组（FFP：CRBC=1：1，n=44）；比较3组凝血指标、住院时间、病死率以及24h内输注红细胞量、血小板量、冷沉淀量的差异。结果大量输血后，中比例组和高比例组凝血酶原时间（PT）、部分促凝血酶原时间（APTT）、纤维蛋白原（FIB），3项凝血指标与低比例组相比，差异有统计学意义（P〈0．05）；但大量输血后，3组住院时间、病死率及24h内输注红细胞量、血小板量、冷沉淀量的差异均无统计学意义（P〉0．05）。结论大量输血时，适度提高血浆输注的比例，有利于预防患者发生凝血功能障碍。

The effects of blood transfusion with different plasma to CRBC ratio on coagulationfunction of patients with massive blood transfusion

Objective To investigate the effects of blood transfusion with different fresh frozen plasma （FFP） to concentrated red blood cells（CRBC） ratio on patients with massive blood transfusion. Methods 97 cases of massive blood transfusion were stud- ied retrospectively. Patients were divided into 3 groups according to the ratio of FFP to CRBC in the blood transfusion of the first 24, which were Low Ratio Group （FFP ： CRBC = 1 ： 3, n =20）, Middle Ratio Group （ FFP ： CRBC = 1 ：2, n = 33）, High Ratio Group（FFP ： CRBC= 1 ： 1, n = 44）. The blood transfusion indexes, length of stay （LOS）, death rate, total units of RBCs, platelet in the first 24 hours were analyzed. Results After blood transfusion among the 3 groups,there was significant difference in coagula- tion function indexes（PT, FIB, APTT） after massive transfusion. However, among the 3 groups, there were no significant difference in LOS,death rate and total units of RBCs, platelet in the first 24 hours（P〉0.05）. Conclusion When massive blood transfusion was performed on patients,moderately elevate the ratio of FFP to CRBC was helpful in the prevention of coagulation disturbance in patients with massive blood transfusion.