冷沉淀在抢救大量输血后凝血异常中作用的观察

目的　观察输注冷沉淀对大量输血后凝血异常的作用。方法　对 8例严重损伤大量输血后有凝血异常的病人 ,行输冷沉淀前、输冷沉淀后 12～ 2 4小时和输后 3～ 5天凝血象及血浆Fn水平测定。结果8例患者输注冷沉淀后 12～ 2 4小时及输后 3～ 5天与输注前相比 ,患者的凝血酶原时间 (PT)、凝血酶时间(TT)、部分凝血活酶时间 (APTT)均明显缩短 ,纤维蛋白原 (Fbg)含量增加 ,血浆纤维结合蛋白 (Fn)水平显著提高 (P <0 .0 0 1) ,5例患者D 二聚体转为阴性。结论　对大量输血后并发凝血异常的患者及时输注冷沉淀可提高血循环中凝血因子及纤维蛋白原等凝血物质的含量 ,缩短凝血时间 ,纠正凝血异常

Effects of cryoprecipitate on the patients with disturbance of blood coagulation after massive blood transfusion

Objective To observe the effect of cryoprecipitate rescue on patients who developed disturbance of blood coagulation after massive blood transfusion.?Methods Eight cases suffering disturbance of blood coagulation after massive blood transfusion were used in this study. There are three groups in this study. The blood coagulation mechanism and fibrinogen level were estimated respectively before and 12 24 hours,3 5 days after cryoprecipitate transfused.?ResultsThe prothrombin time (PT), thrombin time (TT),activated partial thromboplastin time (APTT) decreased significantly before transfusion of compared with 12 24 hours and 3 5 days after transfusion(P<0.001). The level of fibrinogen (Fbg)?fibronectin (Fn) was elevated significantly 12-24 hours and 3 5 days after transfusion as compared with before cryoprecipitate transfusion(P<0.001). Fn in plasma was maintained at a high level(P<0.001). In 5 cases who survived. D dimmer in plasma turns to negative. No change was found in 3 cases who dead of fatal complications.?Conclusion The disturbance of blood coagulation after massive blood transfusion could be corrected effectively by cryoprecipitate transfused in patients. The coagulation factors and Fbg in plasma could be increased significantly by cryoprecipitate transfused.