Research on the mechanism of coagulation dysfunction and optimized blood transfusion strategies in patients undergoing massive blood transfusion in orthopedic surgery
骨科手术大量输血患者凝血功能紊乱机制及优化输血策略研究

摘要

目的 探究骨科手术大量输血患者凝血功能紊乱机制及优化输血策略。方法 选取2024年1月-2024年12月本院收治的骨科手术大量输血患者40例进行研究，通过采集患者手术前、输血过程中及输血后的血液样本，检测凝血相关指标，并结合患者的临床资料进行分析。结果 输血前，患者PT、APTT、PLT、Fg等指标均处于正常范围，输血过程中，随着血液输入，PT、APTT开始延长，PLT、Fg含量逐渐下降，输血结束后2小时，PT、APTT显著延长，PLT、Fg含量明显降低。输血中及输血后各指标与术前相比，差异均具有统计学意义（P<0.05）。结论 骨科手术大量输血患者存在复杂的凝血功能紊乱机制，基于此制定的优化输血策略可有效改善患者凝血功能。

Abstract

Objective To investigate the mechanisms of coagulation disorders in patients who receive large volumes of blood transfusions during orthopedic surgery and to optimize transfusion strategies.
Methods A total of 40 patients who underwent orthopedic surgery and received large volumes of blood transfusions at our hospital from January to December 2024 were selected for study. Blood samples were collected before, during, and after the transfusion to measure coagulation-related indicators, and the data were analyzed in conjunction with the patients 'clinical records.
Results Before the transfusion, patients had normal PT, APTT, PLT, and Fg levels. During the transfusion, as blood was infused, PT and APTT began to increase, while PLT and Fg levels gradually decreased. Two hours after the transfusion, PT and APTT were significantly prolonged, and PLT and Fg levels were markedly reduced. The differences in these indicators during and after the transfusion were statistically significant compared to pre-transfusion levels (P<0.05).
Conclusion   Patients who receive large volumes of blood transfusions during orthopedic surgery have complex coagulation disorders. Optimizing transfusion strategies based on these findings can effectively improve patients' coagulation function.