The Comparison Of Different Combination Scheme Of Coagulant For Patient Of Massive Transfusion During Operation

[Objective]Through infusion intervention for Patient of massive transfusion by different combination schemes of coagulant(Concentrated red blood cell ratio Fresh frozen Plasma are respectively 2:1 and 3:1)in operation,to explore the optimized scheme for those patient during opration.[Methods]We collected 20 patients who must be accept massive transfusion undergoing surgery from December in 2007 to December in 2008.Self-designed raw data sheets for enrolled Patients has been used,which recorded every patients general information,including sex,age,weight,height,history of cardiovascular and pulmonary diseases,preoperative laboratory examination results,including ECG,sternum,blood routine examination,blood clotting function,liver function and renal function.Put the 20 patients into two groups at randomly,and take different methodes to intervent for the two groups respectively during operation.When patient went to operation room,we monitored them by aparatus,including ECG,oxygen saturation of pulse,blood interventional arterial pressure and central venous pressure. At the same time,take haemodilution for patient.When volum of blood loss reach to 30%blood-volume in operation,we infuse concentrated red blood cell and fresh frozen plasma,concentrated RBC ratio FFP are 2:1 and 3:1 respectively in two groups.Quantity of haemoglobin hold more than 10g/L.When volume of blood lose reach to one blood-volume,we infuse platelet and cryopreciPitate.CVP was keeped in 12-15cmH₂O during the whole operation,put patient into SICU with tracheal catheter after oparation.Whether or not ooze blood from the wound surface was recorded, blood routine examination and blood clotting function are monitored respectively after haemodilution,the volume of blood loss reaching to 30% blood-volume,one blood-volume,150%,2OO%,3OO%…,the end of opration and the second day of SICU.The day of treated in hospital are recorded.The optimization scheme was got by statistical analysis.[Results]â‘ There are no significant differences in APTT,PT,TT,body weigt,clloid and the time of anaesthesia between the two groups(P＞0.05);â‘¡Comparing coagulation function between after- haemodilution and preoperation,in the group A,there are significant differences in APTT and PT(P＜0.05),but the mean do not exceed normal rang.There is no significant difference in TT(P＞0.05).In goup B,there are significant differences in PT(P＜0.05),but the mean do not exceed normal rang.There are no significant differences in APTT and TT(P＞0.05).â‘¢Comparing the coagulation function between intra-operation and after-operation,there are no significant differences in APTT and TT in the two group(P＞0.05).But there are significant differences in PT(P＜0.05).As a whole there are no significant differences between two group in coagulation function.â‘£There are no significant differencs in the time of hospitalization between the two group(P＞0.05).[Conclusion]â‘ There is no coagulation function disorder during AHHD with succinylated Gelatin(20mL/kg).â‘¡Differet combination schemes of coagulant(2:1 and 3:1) both can keep normal coagulation function.â‘¢There are no significant differencs in the time of hospitalization between the two groups.â‘£The scheme(3:1) can saving FFP in a certain extent.but if come forth massive transfusion continued,the scheme(2:1) is true of physiological need。...