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目的比较输注新鲜冰冻血浆和(或)冷沉淀凝血因子对原发性肝癌术后凝血功能异常患者的止血效果。方法选择90例原发性肝癌术后凝血功能异常患者,随机分为A组、B组和C组各30例,A组输注新鲜冰冻血浆,B组输注冷沉淀凝血因子,C组输注新鲜冰冻血浆联合冷沉淀凝血因子,比较三组患者输注前1 h和第2次输注结束后24 h的凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)。结果三组患者输注新鲜冰冻血浆或(和)冷沉淀凝血因子前1 h,PT、APTT、TT及FIB检测结果相似,差异均无统计学意义(P>0.05)。第2次输注后24 h,患者PT、APTT、TT及FIB检测结果与本组输注前1 h比较,PT、APTT、TT水平降低,FIB水平升高,差异均有统计学意义(P<0.05),并且C组患者PT、APTT、TT及FIB均纠正到正常值范围内。第2次输注后24 h,C组患者PT、APTT、TT水平较A组、B组均降低,差异均有统计学意义(P<0.05);C组患者FIB与A组比较,差异有统计学意义(P<0.05),与B组比较,差异无统计学意义(P>0.05)。A组与B组患者PT、APTT、TT水平相似,差异无统计学意义(P>0.05);A组患者FIB较B组明显偏低,差异有统计学意义(P<0.05)。三组患者术中出血量、输血量相似,差异均无统计学意义(P>0.05)。术后腹腔引流量A组最多、C组最少、B组居中,差异有统计学意义(P<0.05)。结论单独或联合输注新鲜冰冻血浆、冷沉淀凝血因子均可改善原发性肝癌术后凝血功能异常患者的凝血功能,但是联合输注效果更好,对血液具有保护作用。
Objective To compare the hemostatic effects of fresh frozen plasma and / or cryoprecipitate on patients with postoperative coagulation abnormalities in patients with primary liver cancer. Methods Ninety patients with primary hepatic carcinoma who had abnormal coagulation function were randomly divided into three groups: group A, group B and group C, group A received fresh frozen plasma, group B received infusion of cryoprecipitate, group C Note the fresh frozen plasma combined with cryoprecipitated coagulation factors, compared the three groups of patients before 1 h infusion and after the second infusion of 24 h after the prothrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB). Results The results of PT, APTT, TT and FIB 1 h before fresh frozen plasma or (or) cryoprecipitated blood coagulation were compared in three groups, with no significant difference (P> 0.05). The results of PT, APTT, TT and FIB 24 h after the second infusion showed that the levels of PT, APTT and TT were decreased and the level of FIB was increased in comparison with that before 1 h of infusion (P <0.05), and C, PT, APTT, TT and FIB were corrected to the normal range. The levels of PT, APTT and TT in group C were significantly lower than those in group A and group B at 24 h after the second infusion (P <0.05). There was a significant difference between group C and group A Statistical significance (P <0.05), compared with the B group, the difference was not statistically significant (P> 0.05). The levels of PT, APTT and TT were similar in group A and group B, with no significant difference (P> 0.05). The FIB in group A was significantly lower than that in group B (P <0.05). Three groups of patients with intraoperative blood loss, blood transfusion were similar, the difference was not statistically significant (P> 0.05). The amount of abdominal drainage after operation was the highest in group A, the lowest in group C, and the lowest in group B, with a significant difference (P <0.05). Conclusion Both fresh frozen plasma and cryoprecipitated coagulation factors can improve the coagulation function in patients with primary hepatic carcinoma after coagulation dysfunction. However, the combined infusion is better and has a protective effect on the blood.