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在接受大量输血的严重重创伤患者中,输血比率和生存率

Toru Takiguchi^1,2, Tomohisa Seki³, Takashi Tagami^4,5

¹Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan. toru-takiguchi@nms.ac.jp.

Scientific reports

|July 15, 2025

概括

对于严重创伤患者的最佳血液产品比率尚不清楚. 较高的新鲜冷血 (FFP) 与包装红细胞 (pRBC) 的比率,特别是1-1.5,改善了生存率. 特别是在带有冲击的骨干创伤中特别注意到这一点.

科学领域:

创伤外科手术创伤外科
血液性冲击管理血液性冲击管理
输血医学输血医学

背景情况:

大规模输血协议对于严重创伤患者至关重要.
血液制品 (红细胞,新鲜冷血,血小板) 的最佳比例尚未得到确立.
形创伤患者通常需要大量的血液制品.

研究的目的:

为了确定需要大量输血的严重重创伤患者的最佳输血比率.
调查新鲜冷血 (FFP) 与包装红细胞 (pRBC) 和血小板度 (PC) 与pRBC的比率和住院生存率之间的关联.
为了分析不同创伤表型中的这些比率.

主要方法:

使用日本创伤数据库 (2019-2022) 进行全国性的回顾性队列研究.
包括在24小时内接受≥10单位PRBC的患者.
分析的FP:pRBC和PC:pRBC比率 (0-0.5,0.5-1,1-1.5,1.5-2,>2) 和患者的表型.

主要成果:

1-1.5的FP:pRBC比率与显著更高的住院生存率 (aOR 1.46) 有关.
一个PC:pRBC比为1.5-2显示了改善生存率 (aOR 1.62) 的趋势.
在带有冲击的骨干创伤中,FFP:pRBC比率为1-1,5和>2改善了生存率.

结论:

较高的FFP:pRBC比率,特别是1-1.5,与严重的重创伤中改善的生存率有关.
更高的PC:pRBC比率也可能改善存活率.
这些发现特别适用于管理带有冲击的骨干创伤.

关键词:

这是一个不的创伤.集群集成是指集群集成.大规模的输血输血.冲击和冲击是一个很好的选择.输血比率输血比率输血比率输血比率干部创伤的创伤.

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