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在新鲜冷血和前血复合物缩剂输血后的血栓栓塞并发症和危险因素,以逆转抗凝血

İsmail Ataş¹, Özlem Bilira¹, Mümin Murat Yazıcı¹

¹Recep Tayyip Erdoğan University Training and Research Hospital, Department of Emergency Medicine, Rize, Türkiye.

Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis

|March 10, 2026

概括

用于紧急逆转抗凝血的新血复合缩剂 (PCC) 和新鲜冷血 (FFP) 显示出类似的血栓栓塞并发症 (TEC) 发生率. 高龄和并发症,而不是逆转剂,可能会导致TEC风险.

科学领域:

紧急医疗紧急医疗
血液学血液学血液学
药理学药理学是指药理学的学科.

背景情况:

危及生命的出血往往需要使用前热复合缩物 (PCC) 或新鲜冷血 (FFP) 快速逆转抗凝.
无论是PCC还是FFP,都带有潜在的血栓栓塞并发症 (TEC) 风险.
这项研究调查了接受PCC或FFP用于抗凝固逆转的患者的TEC发病率和相关风险因素.

研究的目的:

为了比较需要紧急逆转抗凝血的患者中,前热血素复合缩剂 (PCC) 和新鲜冷血 (FFP) 之间的血栓栓塞并发症 (TEC) 的发生率.
在这个患者群体中识别与TEC相关的风险因素.

主要方法:

从2022年5月到2024年10月,对与口服抗凝剂相关的严重出血的成年患者 (≥18岁) 的回顾性分析.
收集的数据包括人口统计,出血特征,抗凝剂类型,实验室值和TEC (早期和晚期) 的发生率.
PCC和FFP组之间的TEC发病率的比较,统计学意义设置为p < 0.05.

主要成果:

总共分析了315名患者,42.5%接受PCC,57.5%接受FFP. 华法林是最常见的抗凝剂.
总体TEC发病率为8.3% (PCC:6.7%,FFP:9.4%),两组之间没有显著差异 (p=0.39).
心肌梗塞,不稳定性心痛和缺血性中风是最常见的TEC. 膜心脏病是TEC唯一确定的风险因素 (p=0.04). 经过PCC,凝血参数的纠正速度更快.

结论:

与新鲜冷血 (FFP) 相比,用于重大出血中的紧急抗凝率逆转的前列红素复合缩剂 (PCC) 使用与较高的血栓栓塞并发症 (TEC) 风险无关.
在患有并发症的老年人群中,TEC事件可能主要反映了潜在的患者风险,而不是选择逆转剂.
在逆转疗法后,密切监测患者和迅速重新启动抗凝药非常重要.

关键词:

反凝血逆转抗凝血逆转应急部门的紧急情况.新鲜冷的血.复合物缩物复合物缩物血栓栓塞的并发症血栓塞的并发症

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