围术期输注FFP对脊柱侧弯后路矫形术患者凝血功能的影响
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摘要
目的:探讨围术期输注新鲜冰冻血浆(FFP)对脊柱侧弯后路矫形术患者凝血功能的影响。方法:选取2016年1月至2018年10月于我院行脊柱侧弯后路矫形术患者104例。比较两组自体血回输、异体悬浮红细胞输注和FFP新鲜冰冻血浆输注比例,以及术前3d和术后3d的PT、TT、APTT、FIB、D-D、ACT、CR、PF情况。统计两组患者住院时间和伤口愈合情况。结果:FFP组自体血回输、异体悬浮红细胞输注和FFP输注比例均显著高于非FFP组(P <0.05)。术前3d和术后3d,两组PT、TT、APTT、FIB、D-D、ACT、CR、PF比较差异均无统计学意义(P>0.05)。两组住院时间和Ⅰ级伤口愈合比例比较差异均无统计学意义(P>0.05)。结论:脊柱侧弯后路矫形手术患者围术期输注FFP并不能改善其凝血功能,也未对患者预后产生明显的影响。
Objective: To investigate the effects of perioperative infusion of fresh frozen plasma( FFP on coagulation function in patients undergoing scoliosis surgery. Methods: 104 patients with scoliosis were selected from January 2016 to October 2018. The proportions of autologous blood transfusion,allogeneic suspended red blood cell transfusion and FFP transfusion were compared between the two groups,and the status of PT,TT,APTT,FIB,D-D,ACT,CR and PF at 3 days before operation and 3 days after operation were compared. The hospitalization time and wound healing of the two groups were counted. Results: The proportions of autologous blood transfusion,allogeneic red blood cell infusion and FFP transfusion in FFP group were significantly higher than those in non-FFP group( P <0.05). There was no significant difference in PT,TT,APTT,FIB,D-D,ACT,CR and PF between the two groups before and 3 days after operation( P >0.05).There was no significant difference in the length of hospital stay and Grade I wound healing between the two groups( P >0.05). Conclusion: Perioperative infusion of FFP in patients undergoing posterior scoliosis surgery does not improve their coagulation function,nor does it have a significant impact on the prognosis of patients.
Objective: To investigate the effects of perioperative infusion of fresh frozen plasma( FFP on coagulation function in patients undergoing scoliosis surgery. Methods: 104 patients with scoliosis were selected from January 2016 to October 2018. The proportions of autologous blood transfusion,allogeneic suspended red blood cell transfusion and FFP transfusion were compared between the two groups,and the status of PT,TT,APTT,FIB,D-D,ACT,CR and PF at 3 days before operation and 3 days after operation were compared. The hospitalization time and wound healing of the two groups were counted. Results: The proportions of autologous blood transfusion,allogeneic red blood cell infusion and FFP transfusion in FFP group were significantly higher than those in non-FFP group( P <0.05). There was no significant difference in PT,TT,APTT,FIB,D-D,ACT,CR and PF between the two groups before and 3 days after operation( P >0.05).There was no significant difference in the length of hospital stay and Grade I wound healing between the two groups( P >0.05). Conclusion: Perioperative infusion of FFP in patients undergoing posterior scoliosis surgery does not improve their coagulation function,nor does it have a significant impact on the prognosis of patients.
引文
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[2] Scheer JK,Sethi RK,Hey LA,et al.Results of the 2015 scoliosis research society survey on single versus dual attending surgeon approach for adult spinal deformity surgery[J].Spine,2017,42(12):932~942.
[3] Innerhofer P,Fries D,Mittermayr M,et al.Reversal of trauma-induced coagulopathy using first-line coagulation factor concentrates or fresh frozen plasma(RETIC):a single-centre,parallel-group,open-label,randomised trial[J]. The Lancet Haematology,2017,4(6):e258~e271.
[4] Steiner T,Poli S,Griebe M,et al.Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists(INCH):a randomised trial[J].The Lancet Neurology,2016,15(6):566~573.
[5] Müller MC,Arbous MS,Spoelstra‐de Man AM,et al.Transfusion of fresh‐frozen plasma in critically ill patients with a coagulopathy before invasive procedures:a randomized clinical trial(CME)[J]. Transfusion,2015,55(1):26~35.
[6] Schouten M,van‘t Veer C,Poulussen N,et al.The cytoprotective effects of endogenous activated protein C reduce activation of coagulation during murine pneumococcal pneumonia and sepsis[J]. Thrombosis research,2015,135(3):537~543.
[7] Martirosov DM,Bidell MR,Pai MP,et al. Relationship between day 1 and day 2 vncomycin area under the curve values and emergence of heterogeneous Vancomycin-intermediate Staphylococcus aureus(h VISA)by among patients with MRSA bloodstream infections:a pilot study[J]. BMC infectious diseases,2017,17(1):534.