血小板联合冷沉淀输注对大出血患者凝血功能的影响.docVIP

血小板联合冷沉淀输注对大出血患者凝血功能的影响 　　摘要：目的 探讨血小板联合冷沉淀输注对大出血患者凝血功能的影响。方法 选取2013年7月～2016年5月进行大量输血治疗的急性大出血患者154例随机分组，将血小板联合输注冷沉淀的患者设定为联合组，单独输注血小板的患者设为血小板组，单独输注冷沉淀的患者设为冷沉淀组。对患者输注前1 h和输注后24 h内的凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血酶时间（APTT）、纤维蛋白原（Fbg）和血小板（PLT）进行统计分析，并观察患者止血效果，住院天数和生存率以及输注的血液制品量。结果 患者联合输注后24 h内的TT、PT和APTT与对照组相比明显缩短（P0.001），Fbg与血小板组相比明显增加（P0.001），PLT与冷沉淀组相比明显增加（P0.001）。联合组的平均止血时间更短（3.7±2.2）h，平均止血率更高（91%），住院时间更短（22.5±5.6），生存率更高（89.29%）。结论 在大出血患者治疗中，血小板联合冷沉淀输注与单独输注有更加明显的疗效。 　　关键词：出血；凝血；输血；血小板；冷沉淀；联合输注 　　Abstract： Objective To discuss the effects of different transfusion of platelet combined with cryoprecipitate in patients with massive hemorrhage. Methods Totally 54 cases of massive hemorrhage with massive blood transfusion were chosen as the research object in the Affiliated Hospital of Southwest Medical University between July. 2013 and May. 2016. The patients with only infusion of platelet were set as the platelet group， only infusion of cryoprecipitate as the cryoprecipitate group，and platelet combined with cryoprecipitate as the combined group.Prothrombin time（ PT） ，activated partial prothrombin time （ APTT） ， thrombin time （ TT） ， fibrinogen（ FIB） and platelet（ PLT） were statistically analyzed in patients before infusion of 1h and after infusion of 24h among three groups.And to observe the effect of hemostasis， length of stay and survival rate， and the amount of blood products be transfusion. Results TT， PT and APTT of the combined group in 24h were significantly shorter than the control groups（P ?0.001）. Compared with platelet group， Fbg was significantly increased （P 0.001）， and PLT was significantly increased （P 0.001） compared with that of the cryoprecipitate group. In combined group， the average hemostasis time was shorter （3.7±2.2h）， the average hemostasis rate was higher （91%）， and the hospital stay was shorter （22.5±5.6）， and the survival rate was higher （89.29%）. Conclusion The treatment of patients with massive hemorrhage in group of platelet combined wit