Abstract：Objective To investigate the clinical value of individualized blood component transfusion guided by dynamic coagulation monitoring in patients undergoing massive transfusion. Methods A total of 82 severe trauma patients requiring massive transfusion admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group and a control group using a random number table method,with 41 cases in each group.The control group received monitoring of routine coagulation parameters combined with a 1:1:1 ratio transfusion protocol,while the observation group received dynamic thromboelastography(TEG) monitoring combined with a goal-directed individualized transfusion strategy.Changes in coagulation parameters before transfusion and at 24h and 48 h after transfusion were compared between the two groups.The volume of blood components transfused,blood loss,incidence of transfusion-related adverse reactions,and 28-day mortality were recorded in both groups. Results At 24h after transfusion,prothrombin time(PT) and activated partial thromboplastin time(APTT) in the observation group were significantly lower than those in the control group,while fibrinogen(FIB) level was significantly higher(P<0.05).At 48h after transfusion,there was no statistically significant difference in coagulation parameters between the two groups(P>0.05).The volumes of frozen plasma(FFP) and platelet transfusions in the observation group were significantly lower than those in the control group(P<0.01),while there was no significant difference in red blood cell transfusion volume between the two groups(P>0.05).The 24h blood loss in the observation group was lower than that in the control group(P<0.05).The incidence of transfusion-associated circulatory overload in the observation group was lower than that in the control group(P<0.05),and there was no significant difference in 28-day mortality between the two groups(P>0.05). Conclusion The individualized blood component transfusion strategy based on dynamic TEG monitoring can more rapidly correct coagulation dysfunction in patients undergoing massive transfusion,reduce the volume of plasma and platelet transfusions,and decrease the risk of transfusion-associated circulatory overload,serving as an effective approach for achieving precision transfusion therapy.
2026, Vol. 46 
