Saltzherr Teun Peter, Christiaans Sarah C, Henny C Pieter, Levi Marcel M, Goslings J Carel
Academisch Medisch Centrum, Afd. Chirurgie, Trauma Unit, Amsterdam, The Netherlands.
Ned Tijdschr Geneeskd. 2011;155:A2306.
Severe haemorrhage is a significant cause of death in trauma patients. In the case of massive blood loss a combination of coagulation defects, acidosis and hypothermia arise, which are accompanied by high morbidity and mortality rates unless properly corrected. Research in wounded military showed that a high ratio of fresh frozen plasma to packed red blood cells (FFP:PRBC) seemed to have a positive effect on survival. These studies do not provide a definition of the ideal ratio FFP:PRBC; the ratio in which a positive effect is seen varies from 1:1 to 1:3. Unnecessary FFP transfusions in trauma patients without imminent severe haemorrhage increase the risk of complications such as multi-organ failure and acute respiratory distress syndrome. Additional research is required into the accuracy of diagnosis of acute coagulation disorders.
严重出血是创伤患者死亡的重要原因。在大量失血的情况下，会出现凝血功能缺陷、酸中毒和体温过低等情况，除非得到适当纠正，否则会伴随着高发病率和死亡率。对受伤军人的研究表明，新鲜冰冻血浆与浓缩红细胞的比例较高（FFP:PRBC）似乎对生存率有积极影响。这些研究没有给出理想的FFP:PRBC比例的定义；出现积极效果的比例从1:1到1:3不等。在没有立即发生严重出血的创伤患者中不必要地输注FFP会增加多器官功能衰竭和急性呼吸窘迫综合征等并发症的风险。需要对急性凝血障碍诊断的准确性进行更多研究。
