【摘要】 目的 探讨凝血功能监测对降低普外术中大量输血患者并发症发生率的影响。方法 将普外科大量输血的37例患者设为研究组,少量输血的37例患者设为对照组。于输血前后,监测并比较两组电解质、血常规及凝血功能,比较两组围术期并发症发生率。结果 研究组并发症发生率为16.2%,对照组为8.1%,研究组虽高于对照组,但差异无统计学意义（P>0.05）。与输血其他阶段比较,输血后1 h、术毕研究组血清K⁺、凝血酶原时间、国际标准化比值、活化部分凝血酶原时间、凝血酶时间升高,血清Ca²⁺、血清Na⁺、血小板、血红蛋白、红细胞压积、纤维蛋白原水平降低,除Na⁺、K⁺含量外其余指标组内比较差异均有统计学意义（P<0.05或0.01）。对照组输血各阶段电解质、血常规及凝血功能指标检测结果比较差异无统计学意义（P>0.05）。结论 对普外科术中大量输血患者进行凝血功能、电解质监测,有助于发现异常,早期处理,以期降低并发症发生率,提高围术期安全性。更多还原

【Abstract】 Objective To investigate the effect of coagulation function monitoring on reducing complication occurrence rate of massive transfusion patients in general surgical operation. Methods 37 cases with massive transfusion in general surgery department were selected as the observation group, 37 cases with a small amount of transfusion were selected as the control group. Before and after transfusion, electrolyte,blood routine, coagulation function of the two groups were monitored and compared, and perioperative complication occurrence rate of the two groups were compared. Results Complication occurrence rate of the observation group（16. 2%） was higher than that of the control group（8. 1%）, but the difference was not statistic significant（P>0. 05）. Compared with other transfusion phases, serum K⁺,PT, INR,APTT, TT in the observation group at 1 h after transfusion and the end of operation were increased, serum Ca²⁺, serum Na⁺, PLT, Hb, HCT, FIB were declined. Except for Na⁺, K⁺ content, the difference of other indexes between groups had statistic significance（P<0. 05 or 0. 01）. In the control group, the difference of electrolyte,blood routine,coagulation function indexes detection results in all transfusion phases had no statistic significance（P>0. 05）. Conclusion The application of coagulation function, electrolyte monitoring on massive transfusion patients in general surgical operation can help to find abnormity,and early treatment should be given in order to reduce complication occurrence rate and improve perioperative safety.更多还原