2065例地震创伤患者用血特点分析
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摘要
目的研究地震创伤患者输血治疗的特点及规律,为大型自然灾害所致的群体性创伤患者的输血治疗提供参考。方法分析四川省人民医院救治的2 065例512地震创伤患者(排除烧伤患者)不同时段、不同创伤部位用血量。结果230例地震创伤患者输血总量为4 248 U,血液品种包括红细胞制品、新鲜冰冻血浆(FFP)、血小板、冷沉淀,红细胞用量高峰出现最早(5月14日),FFP用量最大;挤压综合征组用血量占地震创伤患者用血总量的65.1%(2 766/4 248),与其他创伤组比较,差异有统计学意义(P<0.05)。结论地震等大型灾难救治早期抢救急性失血性贫血创伤患者以大量红细胞制品输注为主,FFP、血小板及冷沉淀主要用于危重患者的抢救和治疗;对挤压综合征患者进行科学、合理、有效的成分输血治疗对降低地震灾害死亡率具有重要意义。
Objective To provide the information for blood transfusion to the patients injured by severe natural disasters by statistically analyzing characteristic and regularity of blood transfusion from the inpatients injured by earthquake in 2 065 cases from May 12,2008 to July 12,2008.Methods To analyze the quantity of blood transfusion from the inpatients injured by earthquake in different remedy stages and different sites of trauma.Results 230 inpatients injured by earthquake were received blood components and the total amount of transfusion was 4 248 U.The RBC,FFP,platelet and cryoprecipitation all were used,the top of RBC appeared earliest(May 14)and the quantity of FFP was maximum.The quantity of transfusion in the group of crush syndrome accounted for 65.1%(2 766/4 248),compared with other groups(P<0.05).Conclusion Abundant quantity of RBC should be reserved to the patients of acute hemorrhage,FFP and platelet and cryoprecipitation should be reserved to the critically ill patients.It is important to reduce the death rate of the inpatients injured by earthquake by reasonable blood components transfusion to the patients with crush syndrome.
Objective To provide the information for blood transfusion to the patients injured by severe natural disasters by statistically analyzing characteristic and regularity of blood transfusion from the inpatients injured by earthquake in 2 065 cases from May 12,2008 to July 12,2008.Methods To analyze the quantity of blood transfusion from the inpatients injured by earthquake in different remedy stages and different sites of trauma.Results 230 inpatients injured by earthquake were received blood components and the total amount of transfusion was 4 248 U.The RBC,FFP,platelet and cryoprecipitation all were used,the top of RBC appeared earliest(May 14)and the quantity of FFP was maximum.The quantity of transfusion in the group of crush syndrome accounted for 65.1%(2 766/4 248),compared with other groups(P<0.05).Conclusion Abundant quantity of RBC should be reserved to the patients of acute hemorrhage,FFP and platelet and cryoprecipitation should be reserved to the critically ill patients.It is important to reduce the death rate of the inpatients injured by earthquake by reasonable blood components transfusion to the patients with crush syndrome.
引文
[1]孟祥志,傅存菊.挤压损伤——挤压综合征的病理、生理、生化改变[J].法医学杂志,1996,12(1):30-32.
[2]Better OS,Rubinstein I,Reis DN.Muscle crush compart-ment syndrome:ful minant local edema with threaten sys-temic effects[J].Kidney Int,2003,63(3):1155-1157.
[3]Sever MS,Erek E,Vanholder R,et al.Clinical findings inthe renal victi ms of a catastrophic disaster:the Marmaraearthquake[J].Nephrol Dial Transplant,2002,17(11):1942-1949.
[4]Como JJ,Dutton RP,Scalea TM,et al.Blood transfusionuse rates in the care of acute trauma[J].Transfusion,2004,6(44):809-813.
[5]Loren D.Microchi merism:a lasting legacy of transfusion[J].Transfusion,2006,11(46):1856-1858.
[6]Vanholder R,Van Biesen W,Lameire N,et al.The role ofthe international society of nephrology/renal disaster re-lief task force in the rescue of renal disaster victi ms[J].Contrib Nephrol,2007,15(6):2325-2332.
[2]Better OS,Rubinstein I,Reis DN.Muscle crush compart-ment syndrome:ful minant local edema with threaten sys-temic effects[J].Kidney Int,2003,63(3):1155-1157.
[3]Sever MS,Erek E,Vanholder R,et al.Clinical findings inthe renal victi ms of a catastrophic disaster:the Marmaraearthquake[J].Nephrol Dial Transplant,2002,17(11):1942-1949.
[4]Como JJ,Dutton RP,Scalea TM,et al.Blood transfusionuse rates in the care of acute trauma[J].Transfusion,2004,6(44):809-813.
[5]Loren D.Microchi merism:a lasting legacy of transfusion[J].Transfusion,2006,11(46):1856-1858.
[6]Vanholder R,Van Biesen W,Lameire N,et al.The role ofthe international society of nephrology/renal disaster re-lief task force in the rescue of renal disaster victi ms[J].Contrib Nephrol,2007,15(6):2325-2332.
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