大量输血患者及时输注血浆的重要性

目的观察大量输血患者及时监测凝血四项,并及时补充新鲜冷冻血浆对其各项凝血指标的影响。方法选择大量输血的手术患者56例（24h内输入悬浮红细胞〉10U）,将仅输注悬浮红细胞未输注血浆者设为对照组,同时输注悬浮红细胞和输注血浆者设为实验组,监测术前、输血前和输血后的凝血四项和血小板等指标。结果两组患者输血后凝血功能均发生改变,PT、APTT、TT均较输血前延长,而FIB水平下降（P〈0.01）。输血后对照组PT、APTT、TT均较对照组更长,而FIB水平更低,差异具有统计学意义（P〈0.01）,对照组发生出血的危险明显高于实验组。结论在大量输血时,要及时进行机体凝血四项和血小板的监测,有条件的同时进血栓弹力图的监测,及时输注血浆补充凝血因子,以避免不必要的出血,提高输血疗效。

The importance of transfusing fresh frozen plasma for the massive blood transfusing patients

Objective To observe the influence of fresh frozen plasma for the platelet and blood clotting function of the massive blood transfusing patients.Methods Chose 56 patients of massive blood transfusion（transfusion of red blood cell10u in 24 hours）,and divide into two groups： control group（patients who transfused red blood cell only） and experimental group（patients who transfused red blood cell and fresh frozen plasma）.Monitoring the PLT and coagulogram of the patients before and after transfusion.Results After multiplicity blood transfusion,patients with pro thrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT） extending are extremely（P0.01）.The FIB are obviously descending（P0.01）.After multiplicity blood transfusion,the PT、APTT、TT of control group extending are extremely more than he PT、APTT、TT of experimental group（P0.01）,and the FIB are obviously descending more than he PT、APTT、TT of experimental group（P0.01）.Conclusion When multiplicity blood transfusion,we should dynamically monitor the thrombin function and the PLT in time,moreover transfuse FFP in time,to solve the problem to prevent the severity complications and save the life of the patient.