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| Application value of early intervention coagulation strategy in massive transfusion patients with severe trauma |
| LI Xiudan1 HUANG Mingli1▲ QIAN Jun2 LIAO Qunfen3 YANG Tianxing1 ZENG Yali4 |
1.Intensive Medicine Department, Mianyang 404 Hospital, Sichuan Proviunce, Mianyang 621000, China;
2.Intensive Medicine Department, Jiangyou People′s Hospital, Sichuan Province, Jiangyou 621000, China;
3.Intensive Medicine Department, Sichuan Science City Hospital, Sichuan Province, Mianyang 621000, China;
4.Blood Transfusion Department, Mianyang 404 Hospital, Mianyang 404 Hospital, Sichuan Province, Mianyang 621000, China |
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Abstract Objective To explore the application value of early intervention coagulation strategy in patients with massive transfusion after severe trauma. Methods From March 2017 to March 2018, 44 patients with severe trauma requiring massive blood transfusion during the period of early intervention coagulation strategy in Mianyang 404 Hospital of Sichuan ("our hospital" for short) were selected as the research group, 44 patients with severe trauma requiring massive blood transfusion during the period of routine blood transfusion in our hospital from February 2016 to February 2017 were selected as the control group. The incidence, mortality, blood gas analysis and coagulation function of acute respiratory distress syndrome (ARDS) were compared between the two groups. Results After the intervention, the incidence and mortality of ARDS in the study group were lower than those in the control group (P ＜ 0.05); 1 and 5 days after transfusion, pH and partial arterial oxygen pressure (PaO2) in the study group were higher than those in the control group, and partial carbon dioxide pressure (PaCO2) were lower than those in the control group (P ＜ 0.05); 1 d after transfusion, Prothrombin time (PT), activation time of partial thrombin (APTT) and thrombin time (TT) were all lower in the study group than in the control group, while fibrinogen (FIB) and platelet count (PLT) were higher in the study group than in the control group (P ＜ 0.05); 5 d after transfusion, PT, TT, FIB and PLT in the study group were all higher than those in the control group, and APTT was lower than that in the control group (P ＜ 0.05). Conclusion Early intervention of coagulation strategy in patients with severe trauma and massive transfusion can reduce the incidence and mortality of ARDS, improve blood gas analysis, and reduce the impact on coagulation function.
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