术中血浆与红细胞输注比例对心脏外科手术患者预后的影响

目的 探讨术中血浆与红细胞输注比例（血浆/红细胞）对心脏外科手术术中输血患者预后的影响。方法 收集723例心脏外科手术术中输血患者的临床资料，根据输血量将其分为大量输血组（输血量≥8 U，282例）和非大量输血组（输血量< 8 U，441例），2组再按血浆/红细胞进一步分为高比例组与低比例组2个亚组（高比例组：血浆/红...

Effect of intraoperative plasma-to-red blood cell transfusion ratio on prognosis of patients undergoing cardiac surgery

Objective To evaluate the effect of plasma-to-red blood cell transfusion ratio on clinical prognosis of patients undergoing blood transfusion during cardiac surgery. Methods Clinical data of 723 patients receiving blood transfusion during cardiac surgery were collected. According to the amount of blood transfusion, they were divided into the massive transfusion group (blood transfusion≥8 U,n = 282) and non-massive transfusion group (blood transfusion < 8 U,n = 441). Two groups were further divided into 2 subgroups according to the plasma-to-red blood cell transfusion ratio (high ratio subgroup： plasma-to-red blood cell ratio>1； low ratio subgroup： plasma-to-red blood cell transfusion ratio≤1), the influence of plasma-to-red blood cell transfusion ratio on clinical prognosis of patients was evaluated. Results In the massive transfusion group, the amount of postoperative plasma transfusion was significantly increased, postoperative hemoglobin level was significantly lower, postoperative activated partial thromboplastin time (APTT) was prolonged, postoperative international normalized ratio (INR) was lower, the length of postoperative hospital stay, postoperative ICU stay and postoperative mechanical ventilation time were significantly longer in the low ratio subgroup compared with those in the high ratio subgroup (all P < 0.05). In the non-massive transfusion group, postoperative hemoglobin level and hematocrit in the low ratio subgroup were significantly higher than those in the high ratio subgroup (both P < 0.05),but there were no significant difference between two subgroups about the length of postoperative hospital stay, postoperative ICU stay,postoperative mechanical ventilation time and in-hospital mortality rate(all P > 0.05). Conclusions For patients receiving massive blood transfusion during cardiac surgery, high plasma-to-red blood cell transfusion ratio is more conducive to clinical prognosis. For those with non-massive transfusion, there is no need for excessive plasma transfusion.