特大地震致严重挤压综合征8例的输血疗效分析
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摘要
目的总结特大地震致严重挤压综合征的输血治疗经验。方法对8例不同程度挤压伤输注的悬浮红细胞及输注量进行分析,观察输血疗效,输血前后Hb变化,组织渗血情况。结果2例分别行截肢及脑出血手术治疗,输血量较少,红细胞无效输注率低,渗血及时控制,预后良好;6例分别行坏死组织切除清创术或截肢术及连续肾脏替代治疗,输血量大,红细胞无效输注率高,出血渗血严重,愈后差。结论严重挤压综合征患者的输血量与其预后呈负相关。
Objective To study the effect of blood transfusion on earthquake injuries with crush syndrome in WenChuan earthquake.Methods The amount of red blood cell suspension given to the earthquake victims were studied. The transfusion effect, Hb concentrations, and capillary hemorrhage of tissues of the injuries were also observed.Results Two victims, who underwent amputation surgery and cerebral hemorrhage operation, received a relatively small amount of transfusion, and showed a good transfusion effect and prognosis. While the other 6 victims, who underwent amputation surgery, surgical debridement, or continuous renal replacement therapy, received a large amount of blood, and showed a bad transfusion effect and prognosis.Conclusion The amount of blood transfusion in patients with crush syndrome was correlated negatively with the outcome.
Objective To study the effect of blood transfusion on earthquake injuries with crush syndrome in WenChuan earthquake.Methods The amount of red blood cell suspension given to the earthquake victims were studied. The transfusion effect, Hb concentrations, and capillary hemorrhage of tissues of the injuries were also observed.Results Two victims, who underwent amputation surgery and cerebral hemorrhage operation, received a relatively small amount of transfusion, and showed a good transfusion effect and prognosis. While the other 6 victims, who underwent amputation surgery, surgical debridement, or continuous renal replacement therapy, received a large amount of blood, and showed a bad transfusion effect and prognosis.Conclusion The amount of blood transfusion in patients with crush syndrome was correlated negatively with the outcome.
引文
[1]甘茂周,兰炯采,贠中桥,等.慢性再生障碍性贫血患者红细胞输注的临床疗效初探[J].中国输血杂志,2008,21(1):6—7
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[7]罗志强,蒋筱强.输血不足与输血过量对外科病人的影响[J].中国实用外科杂志,2007,27(2):116—118
[8]赵绥民,田兆嵩.急性失血病人的成分输血[J].中国输血杂志,1999,12(1):45—48
[2]鲁天瑜,竞花兰.挤压综合征的法医学研究进展[J].中国法医学杂志,2006,21(4):226—228
[3]李洪文,陈雁林,赵善群,等.严重挤压伤及挤压综合征6例报告[J].贵州医学,2005,29(11):1014—1016
[4]何静,熊鸿燕,陈方祥,等.创伤输血的研究进展[J].中华创伤杂志2006,22(4):316—318
[5]Mostafa G,Gunter OL,Norton HJ,et al.Age,blood transfusion,and survival after trauma[J].Am Surg,2004,70(4):357—363
[6]Sittig KM,Deitch EA.Blood transfusion:for the thermally injured or for the doctor[J]?J Trauma,1994,36(5):369—372
[7]罗志强,蒋筱强.输血不足与输血过量对外科病人的影响[J].中国实用外科杂志,2007,27(2):116—118
[8]赵绥民,田兆嵩.急性失血病人的成分输血[J].中国输血杂志,1999,12(1):45—48
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