成分输血对急性失血患者酸碱平衡的影响

目的：探讨成分输血对急性失血患者酸碱平衡的影响。方法：对88例急性失血患者进行输血前及输血后定时血气分析监测,根据血气监测结果分析成分输血对酸碱平衡的影响。结果：观察期间14例患者存在其他影响酸碱平衡因素退出。纳入分析的74例中,44例输血前存在不同程度代谢性酸中毒的患者输血后26例酸中毒消失,17例减轻,1例略加重。74例患者中输血后发生输血相关性碱中毒24例,其24h内新鲜冰冻血浆（FFP）平均用量2063ml,明显高于非碱中毒患者。输血相关性碱中毒的病例未使用酸性药物进行治疗,停止输血后13～48h自动恢复。结论：急性失血患者输血前大部分存在程度不同的代谢性酸中毒。经有效止血、输血后多能缓解。成分输血对急性失血患者酸碱平衡的影响主要表现为代谢性碱中毒,代谢性酸中毒罕见。输血相关性碱中毒一般为自限性,停止输血后可自行恢复。

The acid-base balance influence of blood component transfusion on acute blood loss patients

Objective:To investigate the acid-base balance influence of blood component transfusion on acute blood loss patients. Methods:We detected the blood gas analysis of 88 acute blood loss patients before and after blood component transfusion, to analyze the acid-base balance influence of blood component transfusion according to the blood gas analysis. Results:Fourteen patients were quit for the acid-base balance influence of other factors during the observation, Seventy-four patients were bring into the acid-base balance analysis; Among the forty-four patients with different degree acidosis before, Twenty-six patient's acidosis vanished after blood component transfusion,Seventeen patient's acidosis alleviated af-ter blood componenttransfusion, One patient's acidosis aggravated slightly after blood component transfusion;Twenty-four patients had blood transfusion relevent alkalosis in all seventy-four patients after transfusion, And their average usage amount of fresh frozen plasma (FFP) was 2 063 ml in 24 hours, It was much high than those patients without alkalosis; The patients with blood transfusion relevent alkalosis would be self-recovery within 13-48 hours after stop blood transfusion, without using any acidity medicine. Conclusion:Most of acute blood loss patients has different degree acidosis before blood transfusion. It would be relieved after effective hemostasis and blood transfusion; The principal influence of blood compo-nent transfusion on acute blood loss patients is alkalosis, and acidosis was very rare;The blood transfusion relevent alkalosis is self limited commonly. It would be self-recovery after hemostasis and blood transfusion.