Efficacy Analysis of Different Transfusion Ratio Strategies in the Treatment of Severe Traumatic Hemorrhage

XIONG Xiaomei; WANG Wentian; HUANG Lihua

doi:10.13919/j.issn.2095-6274.ZHJY202508035

Abstract：Objective To investigate the impact of different plasma-to-red blood cell(RBC)transfusion ratios on the therapeutic outcomes in patients with severe traumatic hemorrhage.Methods A total of 98 patients with severe trau-matic hemorrhage admitted to The First Hospital of Longyan from January 2023 to December 2024 were selected as the study subjects.Based on the actual transfused plasma-to-RBC ratio,patients were divided into a low-ratio group(plasma∶RBC<1∶2,n=32),a medium-ratio group(1∶2≤ratio≤1∶1,n=34),and a high-ratio group(ratio>1∶1,n=32).Coag-ulation function,transfusion volumes,complication rates,and mortality were compared among the three groups.Re-sults At 24 hours post-transfusion,there were statistically significant differences in coagulation parameters among the three groups(P<0.05).Prothrombin time(PT)and activated partial thromboplastin time(APTT)in the low-ratio group were significantly longer than those in the medium-and high-ratio groups,while fibrinogen(FIB)was significantly lower(P<0.05).However,there were no significant differences in coagulation parameters between the medium-and high-ratio groups(P>0.05).No significant difference was observed in RBC transfusion volume among the three groups(P>0.05),but there was a significant difference in plasma transfusion volume(P<0.001).The total incidence of complications in the medium-ratio group(11.76%)was significantly lower than that in the low-ratio group(37.50%)and the high-ratio group(43.75%)(P<0.05).Regarding mortality,the 24-hour mortality rates in both the medium-and high-ratio groups were sig-nificantly lower than that in the low-ratio group(P<0.05).The 30-day mortality rate in the medium-ratio group(20.59%)was significantly lower than that in the low-ratio group(46.88%)and the high-ratio group(43.75%)(P<0.05).Conclusion For patients with severe traumatic hemorrhage,employing a plasma-to-RBC transfusion ratio be-tween 1∶2 and 1∶1 demonstrates comprehensive advantages in improving coagulation function,reducing complication rates,and lowering long-term mortality,which can be considered as the preferred transfusion strategy in clinical practice.