不同输血量干预对老年严重创伤患者凝血功能的影响

doi:10.3969/j.issn.1671-7171.2024.01.029

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Abstract 【Objective】 To observe the effect of different transfusion volumes on coagulation function in elderly patients with severe trauma. 【Methods】 A total of 110 severe trauma patients treated in our hospital were randomly divided into an observation group and a control group, with 55 cases in each group. All patients were given basic treatments such as oxygen therapy, anti infection, and anti shock. The control group received a small amount of blood transfusion intervention, while the observation group received a large amount of blood transfusion intervention, closely monitoring the changes in vital signs of patients after blood transfusion intervention. We compared the incidence and mortality rates of inflammation, coagulation function, blood gas, and multiple organ dysfunction syndrome (MODS) in two groups of patients before and three days after intervention. 【Results】 Three days after intervention, the levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α(TNF-α) in the two groups of patients were significantly higher than before intervention (P<0.05), and the levels of various indicators in the observation group were higher than those in the control group (P<0.05); Three days after intervention, the levels of prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) in two groups of patients were significantly higher than before intervention, while the levels of fibrinogen (FIB) and platelet count (PLT) were significantly lower than before intervention (P<0.05). In addition, the levels of PT, APTT, and TT in the observation group were higher than those in the control group, while the levels of FIB and PLT were lower than those in the control group (P<0.05); Three days after intervention, the pH and arterial oxygen pressure (PaO₂) levels of the two groups of patients were significantly higher than before intervention, and the arterial carbon dioxide pressure (PaCO₂) levels were significantly lower than before intervention (P<0.05). In addition, the pH and PaO₂ levels of the observation group were higher than those of the control group, and the PaCO₂ levels were lower than those of the control group (P<0.05); The incidence and mortality rate of MODS in the observation group were significantly lower than those in the control group (P<0.05). 【Conclusion】 The application of extensive blood transfusion intervention in elderly patients with severe trauma can effectively supplement their blood volume, improve blood gas indicators, and reduce mortality, but it is prone to trigger inflammatory reactions and lead to coagulation dysfunction. Therefore, when applying blood transfusion intervention to elderly patients with severe trauma, it is necessary to reasonably control the transfusion dose and closely monitor relevant indicators such as coagulation function.

Key words： Blood Transfusion Wounds and Injuries Blood Coagulation Aged

Received: 04 July 2023

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R442.9

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2024.01.029 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2024/V41/I1/106

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