摘要
目的探讨急诊输血方案在救治严重创伤患者中的应用效果。方法选取2015年1月~2018年12月江阴市人民医院收治的严重创伤行急诊输血的患者78例作为本研究对象,分为常规治疗组和新方案治疗组,常规治疗组按照原输血流程进行救治,新方案治疗组则采用新的急诊输血方案进行救治,监测两组患者入抢救室时、输血24h后的血红蛋白浓度(Hb)、血小板数量(PLT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT);记录首次输血时间、入院24h内输注新鲜冰冻血浆(FFP)和红细胞悬液(PRBC)数量;统计住ICU时间和病死率。结果新方案治疗组在输血后24h的INR、APTT值较常规治疗组明显缩短(P <0.05)。新方案治疗组首次输血时间较常规治疗组明显缩短(P <0.05),入院24h内输注FFP数量多于常规治疗组(P <0.05)。住ICU时间方面,新方案治疗组明显短于常规治疗组(P <0.05)。结论对于严重创伤患者,早期实施急诊输血方案和止血等综合救治措施,按一定比例输注血制品,能够降低创伤性凝血病发生,提高血制品使用效率。
Objective To investigate the application effect of the emergency blood transfusion scheme in treating the patients with severe trauma.Methods 78 patients with severe trauma who received emergency blood transfusion after they were admitted to Jiangyin People’s Hospital from January 2015 to December 2018 were selected as the subjects of research in this experiment.They were divided into the conventional treatment group and the new scheme treatment group.The conventional treatment group was treated according to the original blood transfusion process,while the new scheme treatment group was treated with the new emergency blood transfusion scheme.The hemoglobin concentration,platelet count,international normalized ratio(INR),activated partial thromboplastin time(APTT)of the two groups of patients when they entered the emergency room and 24 h after blood transfusion were monitored.The time of first blood transfusion and the quantity of fresh frozen plasma(FFP)and packed red blood cells infused within 24 h after admission were recorded.The ICU stay time and the mortality were counted.Results The INR and APTT values of the new scheme treatment group 24 h after blood transfusion were significantly smaller than those of the conventional treatment group(P<0.05).The time of first blood transfusion in the new scheme treatment group was significantly shorter than that in the conventional treatment group(P<0.05),and the quantity of FFP infused within 24 h after admission was larger than that in the conventional treatment group(P<0.05).In terms of the ICU stay time,that of the new scheme treatment group was significantly shorter than that of the conventional treatment group(P<0.05).Conclusion For the patients with severe trauma,early implementation of comprehensive treatment measures such as the emergency blood transfusion scheme and hemostasis,etc.,as well as transfusion of blood products according to a certain proportion,can reduce the occurrence of traumatic coagulopathy and improve the efficiency of blood products.
作者
何喜军
石源
陈剑
张峻峰
HE Xijun;SHI Yuan;CHEN Jian;ZHANG Junfeng(Emergency Department,Jiangyin People’s Hospital,Jiangsu,Jiangyin 214400,China)
出处
《中国医药科学》
2020年第17期250-253,共4页
China Medicine And Pharmacy
关键词
急诊输血
创伤
新鲜冰冻血浆
红细胞悬液
Emergency blood transfusion
Trauma
Fresh frozen plasma
Packed red blood cells
