大量输血后患者相关检验指标变化及其临床意义
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摘要
目的探讨大量输血后患者相关生化指标的变化及临床意义。方法选择2015年4月-2016年4月在本院输血量为2 000 ml~5 000 ml的患者40例作为研究对象,对比分析输血前后电解质(包括Na~+、K~+、Ca~(2+)、Cl~-)、凝血功能[包括凝血时间(PT)、凝血酶原活动度时间(APTT)、出血时间(TT)及纤维蛋白原(Fbg)水平]、血气分析[包括动脉血p H值、血乳酸(Lac)、碱剩余(BE)]指标。结果与输血前比较,BE值增高,Lac值低;输血后K~+水平高于输血前,Ca~(2+)水平低于输血前;输血后患者PT、APTT均大于输血前,上述差异均有统计学意义(P<0.05)。输血前后p H值差异无统计学意义;TT和Fbg输血前后差异无统计学意义(P>0.05)。结论大量输血导致患者内环境变化,需要注意电解质及凝血功能障碍。
Objective To investigate the changes and clinical significance of biochemical indexes in patients with massive blood transfusion. Methods 40 patients with 2 000 ml-5 000 ml blood transfusion from April 2015 to April 2016 in our hospital were selected as the research objects,and electrolyte( including Na~+,K~+,Ca~(2+),Cl~-),coagulation function including coagulation time( PT),prothrombin time activity( APTT),bleeding time( TT) and fibrinogen( Fbg) level,blood gas analysis indicators including arterial blood p H,blood lactic acid( Lac),residual alkali index( BE) were analyzed and compared. Results Comparing with that before blood transfusion,BE value increased,Lac value decreased; level of K~+after blood transfusion was higher than that before transfusion; Ca~(2+)was lower than that before blood transfusion; PT,APTT were higher than that before transfusion,and there was statistical significance in the difference( P < 0. 05). There was no statistical significance on the difference in p H value before and after transfusion; there was no statistical significance in difference of Fbg and TT before and after blood transfusion( P > 0. 05). Conclusion Massive blood transfusions will lead to changes in patient' s environment,which need to pay attention to electrolyte and coagulation disorders.
Objective To investigate the changes and clinical significance of biochemical indexes in patients with massive blood transfusion. Methods 40 patients with 2 000 ml-5 000 ml blood transfusion from April 2015 to April 2016 in our hospital were selected as the research objects,and electrolyte( including Na~+,K~+,Ca~(2+),Cl~-),coagulation function including coagulation time( PT),prothrombin time activity( APTT),bleeding time( TT) and fibrinogen( Fbg) level,blood gas analysis indicators including arterial blood p H,blood lactic acid( Lac),residual alkali index( BE) were analyzed and compared. Results Comparing with that before blood transfusion,BE value increased,Lac value decreased; level of K~+after blood transfusion was higher than that before transfusion; Ca~(2+)was lower than that before blood transfusion; PT,APTT were higher than that before transfusion,and there was statistical significance in the difference( P < 0. 05). There was no statistical significance on the difference in p H value before and after transfusion; there was no statistical significance in difference of Fbg and TT before and after blood transfusion( P > 0. 05). Conclusion Massive blood transfusions will lead to changes in patient' s environment,which need to pay attention to electrolyte and coagulation disorders.
引文
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[7]卢春生,林列坤,曹文平,等.大量输血引起的血清电解质及凝血功能变化的研究[J].检验医学与临床,2013,10(3):291-292.
[8]陈琼,朱长太,钟宁,等.大量输血患者血清电解质浓度动态监测[J].临床输血与检验,2015,17(5):401-403.
[9]朱正洪,苏简文,陈丽娟,等.产后出血患者大量输血前后凝血指标的变化观察[J].现代中西医结合杂志,2015,24(17):1863-1865.
[10]于丽君,朱国标,李翠莹,等.大量输血患者血小板和出凝血功能变化分析[J].国际检验医学杂志,2013,34(23):3252-3254.
[11]刘颖,曹建明,彭阿钦,等.大量输血对严重创伤患者凝血功能影响的研究[J].河北医药,2014(6):845-848.
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[14]王建华.钙离子在大量输血患者中的应用研究[J].当代医学,2012,18(17):103-104.
[15]曾德理,庞丽丽,曾惠琼,等.短期内大量输血患者血清电解质变化分析[J].现代仪器与医疗,2015,21(2):50-52.