大失血患者输注高比例新鲜冰冻血浆的价值研究

目的 研究大失血患者输入不同比例新鲜冰冻血浆与红细胞的临床效果.方法 按照新鲜冰冻血浆与红细胞输入比例的不同,将45例创伤性失血患者分成3组,每组15例,A组输入新鲜冰冻血浆与红细胞比例为≥1∶1,B组输入新鲜冰冻血浆与红细胞比例为=1∶1～1∶2,C组输入新鲜冰冻血浆与红细胞比例为≤1∶2,观察三组患者输血前后血常规及凝血功能指标的变化.结果 输血前三组患者各项血液指标比较无统计学差异（P＞0.05）;输血后24 h,A组Hb、Plt、APTT、PT-INR无明显变化,FIB水平高于输血前,且明显高于B、C组输血后（P＜0.05）;B组APTT、PT-INR较输血前明显延长（P＜0.05）,C组输血后较输血前Plt降低,APTT、PT-INR延长,FIB水平降低（P＜0.05）.三组存活率比较,差异无统计学意义（P＞0.05）.结论 新鲜冰冻血浆与红细胞高比例输入救治创伤性大失血患者,有助于预防凝血功能障碍的发生,改善预后.

Value of high percentage of fresh frozen plasma in patients with large blood loss

Objective To study the clinical effect of different percentage of fresh frozen plasma and erythrocyte in patients with large blood loss. Methods According to different inputs proportion of fresh frozen plasma and erythrocyte, 45 traumatic hemorrhagic patients were divided into 3 groups, 15 cases in each group, patients in group A were given fresh frozen plasma and erythrocyte input （ ratio ≥ 1：1 ）, patients in group B were. given fresh frozen plasma and erythrocyte input （ ratio = 1： 1 to 1： 2）, patients in group C were given fresh frozen plasma and erythrocyte input （ ratio ≤ 1： 2）, blood routine and blood coagulation indicators were observed in the three groups before and after transfusion. Results There was no difference about blood indicators the three groups without blood transfusion （ P 〉 O. 05）. 2dh after transfusion, there was no significant change after the transfusion about Hb, Plt, APTF, PT-INR in group A, FIB levels was higher than before transfusion, and significantly higher than that in group B and C （ P 〈 0. 05 ）. The value of APTr, PT-INR in group B before transfusion was significantly prolonged （ P 〈 0. 05 ）, lower than that before transfusion. After transfusion, the number of Pit was reduced in group C, APTr and PT-INR were prolonged, FIB level was lower（ P 〈 0. 05 ）. There was not statistically significant about the survival rate （P 〉 0. 05）. Conclusions The high proportion of fresh frozen plasma and erythroeyte in the treatment of patients with large blood loss can help prevent the occurrence of coagulopathy, and improve prognosis.