洗涤式自体血回输联合新鲜冰冻血浆预防术后凝血功能障碍

【目的】探讨洗涤自体血回输联合使用新鲜冰冻血浆预防术后凝血障碍的疗效。【方法】选取2012年1月至2013年12月本院收治的大出血患者90例，按照患者的术中失血量大小，将其分为小量组（＜400mL，n＝50）、中量组（400～800mL，n＝20）和大量组（＞800mL，n＝20）。根据回输血量多少与患者凝血功能的量化关系，制定联合新鲜冰冻血浆输注的具体方案。比较分析三组患者纤维蛋白原（FIB）、血小板（PLT）及凝血酶原时间（PT）变化情况。【结果】回输血液后三组患者机体FIB、PLT均较术前显著降低，PT明显延长（P＜0．05）；术后18h三组患者FIB、PLT均较回输血液后明显升高，PT显著缩短（P＜0．05）。【结论】联合新鲜冰冻血浆输注的具体方案能提高洗涤自体血回输的安全性和实用性，有效预防凝血功能障碍的发生。

Study on the Efficacy of Abstergent Autologous Blood Transfusion Combined with Fresh Frozen Plasma in Preventing Coagulation Disorders after Operation

Objective To explore the efficacy of abstergent autologous blood transfusion combined with fresh frozen plasma in preventing coagulation disorders after operation .[Methods] Totally 90 patients with hemorrhea in our hospital from Jan .2012 to Sept .2013 were chosen .According to blood loss volume ,all patients were divided into small volume group（〈400 mL） ,middle volume group（400～800mL） and large volume group（〉800ml） .On the basis of the quantitative relation between blood transfusion volume and coagulation function of patients ,the concrete scheme about the combined fresh frozen plasma transfusion was made .Fibrinogen（FIB） ,platelet（PLT） and prothrombin time（PT ） in 3 groups at different time point were analyzed and compared .[Results] Compared with before blood transfusion ,FIB and PLT in 3 groups after blood transfusion were decreased significantly and PT was prolonged obviously （ P 〈0 .05） .Compared with after blood transfusion ,FIB and PLT in 3 groups 18h after blood transfusion were increased obviously and PT was shortened significantly（ P 〈 0 .05） .[Conclusion]The concrete scheme about the combined fresh frozen plasma transfusion can improve the safety and practicality of abstergent autologous blood transfusion .