# 一名創傷個案需要大量輸血。哪一個比例符合當代平衡式大量輸血方案？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391886&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名創傷個案需要大量輸血。哪一個比例符合當代平衡式大量輸血方案？

## 選項

1. 只給晶體液
2. PRBC : FFP : 血小板 = 1:1:1；平衡比例可減少稀釋性凝血異常並改善存活 **✔ 正確答案**
3. 只給PRBC
4. PRBC : FFP : 血小板 = 10:1

**正確答案: 2**

## 解析

正確（2）：平衡式PRBC : FFP : 血小板 = 1:1:1（PROPPR試驗）可降低稀釋性凝血異常、低體溫、酸中毒（致命三聯徵）。可加入cryoprecipitate、補充鈣（citrate會螯合Ca）、溫熱液體/血品，以及創傷後3小時內給tranexamic acid（TXA）。避免過量晶體液，因其會惡化凝血異常。（1,3,4）過時/不正確。

## 深入解析

記憶提示 MTP =「1:1:1 + TXA + Calcium + Warm」。創傷致命三聯徵 = 低體溫 + 酸中毒 + 凝血異常。避免過量生理食鹽水。

## 臨床情境

情境 34歲創傷個案，第IV級出血；已啟動大量輸血方案。

## 重要概念

- **大量輸血方案** — 24小時內PRBC ≥10單位或1小時內>4單位；啟動1:1:1比例血品。
- **致命三聯徵** — 創傷中的低體溫 + 酸中毒 + 凝血異常；由MTP處理。
- **Tranexamic acid（TXA）** — 抗纖維蛋白溶解藥；若於創傷後3小時內給予可降低死亡率。

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