中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2012年
34期
4129-4132
,共4页
庞剑%赵娜%蒋露%曹琳%温慧敏%周淑娟%白丹%刘敏%李丹%铁晓源%庞丽娜%臧燕%顾海彤
龐劍%趙娜%蔣露%曹琳%溫慧敏%週淑娟%白丹%劉敏%李丹%鐵曉源%龐麗娜%臧燕%顧海彤
방검%조나%장로%조림%온혜민%주숙연%백단%류민%리단%철효원%방려나%장연%고해동
重症监护%医源性贫血%诊断性失血%血液保护
重癥鑑護%醫源性貧血%診斷性失血%血液保護
중증감호%의원성빈혈%진단성실혈%혈액보호
Intensive care%Iatrogenic anemia%Diagnosis blood loss%Blood conservation
目的 研究RICU患者医源性贫血和诊断性失血的关系,以及优化采血前后RICU患者医源性贫血情况的变化.方法 将2011年1月至2012年5月RICU收治的患者符合入选标准者69例纳入研究.其中2011年1-7月符合入选标准的患者37例,设为对照组,按常规采血法采血；2011年8月至2012年5月符合入选标准的患者32例,设为观察组,按减少采血量的优化采血法采血.结果 对照组患者人RICU第7天贫血人数23例,显著多于第1天的6例,差异有统计学意义(x2=16.388,P=0.000)；观察组患者人RICU第1天贫血者14例,第7天贫血者19例,差异无统计学意义(x2=1.564,P=0.211).对照组BLd1-3、BLd4-7、BLd1-7大于观察组,差异有统计学意义(P＜0.05).观察组Hbc1-3、Hbc1-7均小于对照组,差异有统计学意义(P＜0.05),但Hbc4-7差异无统计学意义(P＞0.05).结论 诊断性失血可造成RICU患者医源性贫血,优化采血方式,加强血液保护可降低医源性贫血的发生率.
目的 研究RICU患者醫源性貧血和診斷性失血的關繫,以及優化採血前後RICU患者醫源性貧血情況的變化.方法 將2011年1月至2012年5月RICU收治的患者符閤入選標準者69例納入研究.其中2011年1-7月符閤入選標準的患者37例,設為對照組,按常規採血法採血；2011年8月至2012年5月符閤入選標準的患者32例,設為觀察組,按減少採血量的優化採血法採血.結果 對照組患者人RICU第7天貧血人數23例,顯著多于第1天的6例,差異有統計學意義(x2=16.388,P=0.000)；觀察組患者人RICU第1天貧血者14例,第7天貧血者19例,差異無統計學意義(x2=1.564,P=0.211).對照組BLd1-3、BLd4-7、BLd1-7大于觀察組,差異有統計學意義(P＜0.05).觀察組Hbc1-3、Hbc1-7均小于對照組,差異有統計學意義(P＜0.05),但Hbc4-7差異無統計學意義(P＞0.05).結論 診斷性失血可造成RICU患者醫源性貧血,優化採血方式,加彊血液保護可降低醫源性貧血的髮生率.
목적 연구RICU환자의원성빈혈화진단성실혈적관계,이급우화채혈전후RICU환자의원성빈혈정황적변화.방법 장2011년1월지2012년5월RICU수치적환자부합입선표준자69례납입연구.기중2011년1-7월부합입선표준적환자37례,설위대조조,안상규채혈법채혈；2011년8월지2012년5월부합입선표준적환자32례,설위관찰조,안감소채혈량적우화채혈법채혈.결과 대조조환자인RICU제7천빈혈인수23례,현저다우제1천적6례,차이유통계학의의(x2=16.388,P=0.000)；관찰조환자인RICU제1천빈혈자14례,제7천빈혈자19례,차이무통계학의의(x2=1.564,P=0.211).대조조BLd1-3、BLd4-7、BLd1-7대우관찰조,차이유통계학의의(P＜0.05).관찰조Hbc1-3、Hbc1-7균소우대조조,차이유통계학의의(P＜0.05),단Hbc4-7차이무통계학의의(P＞0.05).결론 진단성실혈가조성RICU환자의원성빈혈,우화채혈방식,가강혈액보호가강저의원성빈혈적발생솔.
Objective To investigate the relationship of iatrogenic anemia and diagnosis blood loss for patients in RICU,and the change of the anemia before and after the optimized phlebotomy.Methods A prospective study was performed including 69 patients in RICU who met the inclusion criteria during January 2011 to May 2012.The patients adopted from January 2011 to July 2011 were assigned into control group (n =37) and from August 2011 to May 2012 were assigned into observation group (n =32).The control group received the conventional phlebotomy,while the observation group received optimized blood collection method aimed at reducing the blood loss volume respectively.Results In the control group the number of patients with anemia at the 7th day was more than that of the 1st day (23 vs 6 ; x2 =16.388,P =0.000) ; there was difference in Hbd1,Hbd3,Hbd7 (P ＜ 0.05) ; the mean daily phlebotomy volume of the first three days was greater than that of the last four days (P ＝ 0.000) ; Hbc1-3 and Hbc1-7 wcre related with BLd1-3,Hbc4-7 was related with BLd4-7 (P ＜0.05) ; BLd1-3,BLd4-7,BLd1-7 were related with APACHE Ⅱ score positively (P ＜ 0.05).In observation group there was no difference in the proportion of patients with anemia between the 7th day and the 1st day (19 vs 14 ;x2 =1.564,P =0.211); Hbd1,Hbd3 and Hbd7 were no difference (P ＞0.05); the average daily blood loss volume of the first three days was greater than that of last four days (P ＜ 0.05) ; Hbc1-3,Hbc4-7,Hbc1-7 were not related with BLd1-3,BLd4-7 and BLd1-7 (P ＞ 0.05).BLd1-3,BLd4-7 and BLd1-7 were unrelated with APACHE Ⅱ scores (P ＞ 0.05).BLd1-3,BLd4-7,BLd1-7,Hbc1-3,Hbc1-7 in the control group were greater than those of the observation group (P ＜ 0.05) ; there was no difference in Hbc4-7 between the two groups (P ＞ 0.05).Conclusions Diagnostic blood loss can cause the iatrogenic anemia of patients in RICU,and optimizing the blood collection method and enhancing blood conservation can reduce the incidence of iatrogenic anemia.
