院前红细胞输血在平时与战时的实施现状与进展

doi:10.3969/j.issn.1671-2587.2021.04.027

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (4): 530-535.DOI: 10.3969/j.issn.1671-2587.2021.04.027

院前红细胞输血在平时与战时的实施现状与进展

程宁, 臧艳, 唐河山, 冯子阳, 钱宝华

200433 上海,海军军医大学第一附属医院输血科

收稿日期:2020-10-20 出版日期:2021-08-20 发布日期:2021-08-18
通讯作者: 钱宝华,男,教授,主任医师,博士生导师,主要从事临床输血,血液管理及血液免疫研究,（E-mail）qianbh1963@163.com。
作者简介:程宁（1981-）,女,山东烟台人,主管技师,硕士,主要从事临床输血检验工作,（E-mail）chning24@163.com。

Received:2020-10-20 Online:2021-08-20 Published:2021-08-18

摘要/Abstract

摘要： 出血是严重创伤患者可预防的死亡原因,急诊医疗服务（emergency medical service, EMS）越来越多地使用输注红细胞进行损伤控制性复苏。然而,对于何时启动院前红细胞输注（pre-hospital transfusion of red blood cells, PHTRBC）还没有统一的指导方针和共识。院前输血触发因素差异很大,涉及生命体征、组织灌注不良的临床体征、护理点测量和院前超声成像。特别是低血压（最常定义为收缩压≤90 mmHg）、心动过速（最常定义为心率≥120次/min）、灌注不良的临床体征（例如毛细血管再充盈时间延长或精神状态改变）和损伤类型（如穿透性伤口）是院前输血的常见启动标准。另外,尽管PHTRBC在平时与战时急救医疗服务中的应用日益广泛,但没有强有力的证据证明其对生存率的影响,需要进行允许因果推论的进一步的研究设计以获得更确凿的证据。PHTRBC结合血浆输注,以及使用个性化的输血标准,在将来可能会显示出更多的优势,应进行进一步的研究。

关键词: 院前红细胞输血, 红细胞, 损伤控制性复苏, 急救医疗服务, 大出血

中图分类号:

R457

程宁, 臧艳, 唐河山, 冯子阳, 钱宝华. 院前红细胞输血在平时与战时的实施现状与进展[J]. 临床输血与检验, 2021, 23(4): 530-535.

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