大量成分输血对患者凝血机制干预分析.docVIP

大量成分输血对患者凝血机制干预分析 　　【摘要】#8195;目的#8195;探讨大量成分输血对患者凝血机制的干预。方法#8195;73例大量成分输血患者, 输注悬浮红细胞量平均11 U, 输注冰冻血浆量平均8 U。输血前、输血后4 h检测凝血指标。 结果#8195;73例患者输血前后凝血因子差异有统计学意义(P均0.01)；血小板显著下降, 差异有统计学意义(P0.01)。结论#8195;大量成分输血对凝血功能有重要影响, 应及时检测凝血因子及血小板, 并通过血液加温以及针对性的补充血小板和凝血因子来减少出血风险。 　　【关键词】#8195;成分输血；凝血指标；血小板 　　 　　Intervention analysis of a large number of component blood transfusion on blood coagulation mechanism DONG Yong-guang.Pingdu Blood Donor Services of Qingdao Blood Station,Qingdao 266700, China 　　【Abstract】#8195;Objective#8195;To analyze intervention of a large number of component blood transfusion on blood coagulation mechanism. Methods#8195;Retrospectively analyzed clinical data of 73 patients with a large number of component blood transfusion. The infusion of suspension red blood cell volume average of 11 U, infusion of average frozen plasma volume of 8 U. Blood clotting index 4 h before and after blood transfusion was detected. Results#8195;73 cases of patients before and after blood transfusion blood coagulation factor had significant changes, the difference was statistically significant(P0.01), blood platelet reducted significantly, the difference was statistically significant(P0.01). Conclusion#8195;A large number of component blood transfusion has important influence on blood coagulation function, blood platelet and clotting factors should be timely detected, and through blood heat and corresponding platelet and blood coagulation factor supplementary to reduce risk of bleeding. 　　【Key words】#8195;Component blood transfusion; Blood coagulation indexes; Blood platelet大量成分输血是外科手术中比较常见的辅助治疗手段, 主要包括：①24 h内输血量大于等于患者有效循环血量［1］； ②24 h内输入超过10 U的悬浮红细胞［2］；③一次连续性输血大于等于患者总血容量的1.5倍［3］。主要用于抢救急性失血所致血溶量急骤减少, 血压快速下降的急危重症患者。大量成分输血对机体的凝血功能具有重要影响, 可造成电解质紊乱、低体温、酸中毒、凝血功能障碍等严重并发症, 甚至发生弥散性血管内凝血(DIC), 若处理不当可造成患者死亡。其主要机理是, 凝血因子以及血小板发生消耗性和稀释性减少［4］。本研究对73例大量成分输血患者进行回顾性分析, 探讨患者输血前后凝血指标的变化情况, 以期为临床输血提供可借鉴的依据。 　　1 资料与方法 　　1. 1 一般资料选取2013年1月~2014年1月来源于本地区三级综合医院的大量成分输血患者输血病历资料73例进行回顾性分析, 排除内科血液疾病、