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产后出血患者输注冷沉淀治疗的效果:一项回顾性队列研究。

Effect of cryoprecipitate transfusion therapy in patients with postpartum hemorrhage: a retrospective cohort study.

机构信息

Advanced Critical Care Center, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.

Department of Obstetrics and Gynecology, Gifu University Hospital, Gifu, Japan.

出版信息

Sci Rep. 2021 Sep 16;11(1):18458. doi: 10.1038/s41598-021-97954-5.

Abstract

To evaluate the effect of cryoprecipitate (CRYO) transfusion in women referred for postpartum hemorrhage (PPH). This retrospective cohort study included patients with primary PPH referred to Gifu University Hospital between April 2013 and March 2020. We analyzed the effect of CRYO transfusion on fluid balance 24 h after the initial examination using a multivariable linear regression model adjusted for several confounding variables. To evaluate whether outcomes were modified by active bleeding, an interaction term of CRYO*active bleeding was incorporated into the multivariable model. We identified 157 women: 38 in the CRYO group (cases) and 119 in the control group. Fluid balance in the aforementioned period tended to decrease in the CRYO group compared with that in the control group (coefficient - 398.91; 95% CI - 1298.08 to + 500.26; p = 0.382). Active bleeding on contrast-enhanced computed tomography affected the relationship between CRYO transfusion and fluid balance (p = 0.016). Other outcomes, except for the overall transfusion requirement, were not significantly different; however, the interaction effect of active bleeding was significant (p = 0.016). CRYO transfusion may decrease the fluid balance in the first 24 h in PPH patients, especially in those without active bleeding.

摘要

评估冷沉淀(CRYO)输血对产后出血(PPH)患者的影响。本回顾性队列研究纳入了 2013 年 4 月至 2020 年 3 月期间因原发性 PPH 而转至岐阜大学医院的患者。我们使用多变量线性回归模型分析了 CRYO 输血对初始检查后 24 小时内液体平衡的影响,该模型调整了几个混杂变量。为了评估结局是否因活动性出血而改变,我们将 CRYO*active bleeding 这一交互项纳入多变量模型。我们共纳入 157 名患者:CRYO 组 38 例(病例组),对照组 119 例。与对照组相比,上述时期 CRYO 组的液体平衡呈下降趋势(系数 -398.91;95%CI-1298.08 至+500.26;p=0.382)。增强 CT 上的活动性出血影响了 CRYO 输血与液体平衡之间的关系(p=0.016)。除了总输血需求外,其他结局无显著差异;然而,活动性出血的交互作用显著(p=0.016)。CRYO 输血可能会降低 PPH 患者前 24 小时的液体平衡,尤其是在无活动性出血的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/8445974/2753cae4200e/41598_2021_97954_Fig1_HTML.jpg

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