目的:探讨不同成分输血比例对创伤大出血患者血栓弹力图(TEG)检测结果的影响及预后分析.方法:本研究为病例对照研究.选取2021年1月至2023年1月医院接受1∶1比例普通冰冻血浆(FP)与红细胞(RBC)治疗的52例创伤大出血患者作为研究对象,并设为观察组,选取同期实施1∶2比例FP与RBC治疗的52例创伤大出血患者设为对照组.对比TEG中的凝血反应时间(R)、凝血凝固时间(K)、凝血形成速率(Angle)、凝血最终强度(MA);凝血功能中的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR);T淋巴细胞亚群中的CD3+、CD4+、CD8+、CD4+/CD8+及患者在ICU停留时间和入院28 d病死率.结果:输血前,2 组 R、K、Angle、MA、APTT、PT、INR、TT、FIB、CD3+、CD4+、CD8+、CD4+/CD8+比较,差异无统计学意义(P＞0.05);输血 24 h 后,观察组的 R、K、FIB、CD8+低于对照组,而 Angle、MA、APTT、PT、INR、TT、CD3+、CD4+、CD4+/CD8+高于对照组(P＜0.05);2组重症监护室停留时间比较,差异无统计学意义(P＞0.05);观察组的入院28 d病死率低于对照组,但差异无统计学意义(P＞0.05).结论:1∶1比例FP与RBC成分输血治疗创伤大出血患者有利于减轻对机体凝血功能和免疫功能的影响.
Influence of different proportion of blood transfusion components on the results of thromboelastography and prognosis analysis of patients with massive traumatic hemorrhage
Objective:To investigate the influence of different proportion of blood transfusion components on the results of thromboelastography(TEG)and prognostic analysis of patients with massive traumatic hemorrhage.Methods:This study was a case-control study.From January 2021 to January 2023,52 patients with traumatic hemorrhage who were treated with ordinary frozen plasma(FP)and red blood cells(RBC)in a ratio of 1∶1 were selected as the research object and set as the observation group.At the same time,52 patients with traumatic hemorrhage who were treated with FP and RBC in a ratio of 1∶2 were selected as the control group,and the co-agulation reaction time(R),coagulation time(K)and coagulation formation rate in TEG were compared.Activa-ted partial thromboplastin time(APTT),prothrombin time(PT)and international normalized ratio(INR)in coag-ulation function;CD3+,CD4+,CD8+,CD4+/CD8+in T lymphocyte subsets,the length of stay in intensive care unit(ICU)and the 28-day mortality after admission were compared.Results:Before transfusion,there was no sig-nificant difference in R,K,Angle,MA,APTT,PT,INR,TT,FIB,CD3+,CD4+,CD8+,CD4+/CD8+be-tween 2 groups(P＞0.05).After 24 hours of transfusion,FIB,R,K and CD8+in observation group were lower than those in the control group,while Angle,MA,APTT,PT,INR,TT,CD3+,CD4+,CD4+/CD8+were higher than those in the control group(P＜0.05).There was no significant difference in length of stay in ICU be-tween the two groups(P＞0.05).The fatality rate at 28 days after admission in the observation group was lower than that in the control group,but the difference was not statistically significant(P＞0.05).Conclusion:1∶1 proportion of FP and RBC component blood transfusion may be beneficial to reduce the influence on coagulation function and immune function of the patients with traumatic hemorrhage.
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