新鲜冰冻血浆融化后不同保存时间及温度对凝血功能的影响

发布时间：2017-12-28 17:07

本文关键词：新鲜冰冻血浆融化后不同保存时间及温度对凝血功能的影响　出处：《中国实验血液学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:探讨新鲜冰冻血浆融化后不同保存时间及温度下凝血功能的变化,为临床合理有效输注新鲜冰冻血浆提供理论依据。方法:留取新鲜冰冻血浆40例,在融浆机37℃25 min融化后均分为2份,1份于(4±2)℃条件下保存,另1份于(25±2)℃条件下保存,所有样本在融化后0、4、24、48和72 h分别进行血栓弹力图检测,同时进行凝血因子Ⅴ、Ⅶ、Ⅷ、Ⅸ活性以及APTT和PT检测,并对每份样本进行需氧菌和厌氧菌血培养。结果:新鲜冰冻血浆融化后在4℃和25℃保存72 h后均能形成稳定血凝块,且无细菌生长,反应凝血因子活性及血凝块特性的ACT和TMA在保存4、24、48和72 h时间点与0 h相比均存在显著差异(P0.05),但同一保存时间点的两个不同温度间无差异。新鲜冰冻血浆融化后保存48和72 h时凝血因子Ⅴ活性水平在4℃与25℃之间存在显著差异(P0.05),25℃温度保存时活性衰减比4℃温度保存时快。结论:新鲜冰冻血浆融化后保存72 h时虽然有部分凝血因子活性的衰减,但仍能形成稳定血凝块,临床血浆输注过程中融化后保存72 h的血浆可用于临床患者凝血因子的补充,尽量避免血液成分的浪费。
[Abstract]:Objective: To investigate the changes of coagulation function after fresh frozen plasma thawing at different storage time and temperature, so as to provide a theoretical basis for rational and effective infusion of fresh frozen plasma. Methods: the specimens from 40 cases of fresh frozen plasma, the pulping machine 37 C 25 min after melting is divided into 2 parts, 1 in (4 + 2) C under the conditions of preservation, the other 1 in (25 + 2) C storage, all samples in 0, 4, 24 after melting, 48 and 72 h respectively Thrombelastogram detection of coagulation factor V, VII, VIII, IX, APTT activity and PT detection at the same time, and for each sample of aerobic and anaerobic bacteria in blood culture. Results: fresh frozen plasma melted at 4 degrees and 25 degrees to save 72 h can form stable blood clots, and no bacterial growth, coagulation factor activity and blood clot reaction characteristics of ACT and TMA in 4, 48 and 24, save 72 h time point compared with 0 h there were significant differences (P0.05) however, two different temperature preservation the same point in time there is no difference between. When the fresh frozen plasma was stored for 48 and 72 h, there was a significant difference in coagulation factor V activity between 4 and 25 degrees (P0.05). When the temperature was 25, the activity decay rate was faster than that at 4 degrees. Conclusion: fresh frozen plasma melt preserved after 72 h although some attenuation of coagulation factor activity, but still can form a stable blood clot, clinical plasma melt injection process after 72 h plasma can be used to supplement the clinical patients with coagulation factor, avoid the waste of blood components.
【作者单位】：航天中心医院输血科;
【分类号】：R457.1
【正文快照】： J Exp Hematol 2017;25(3):911-915新鲜冰冻血浆是临床常用的一种稀缺医疗资源,主要用于纠正患者凝血功能障碍,输注前需经过37℃融化,其质量和输注安全一直备受关注。传统理论认为新鲜冰冻血浆在融化后应立即给患者输注,但是临床治疗中经常会发生血浆已经融化但无法立即给患者

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