CAJ | 학술논문

目的：通过对重症医学科（ICU）中贫血的机械通气患者实施限制性输血及开放性输血，比较两种不同的输血策略对患者的预后的影响。方法选择2012年6月-2014年6月期间入住我院重症医学科的需机械通气的贫血患者120例，随机分为限制性输血组（输血指征Hb≤70g/L；目标Hb71-90g/L)和开放性输血组(输血指征Hb≤90g/L；目标Hb91-110g/L)。比较两组的红细胞用量、平均血红蛋白值、机械通气时间、器官衰竭数量、ICU住院时间及病死率。结果两组患者的平均红细胞用量、干预后的Hb平均值以及机械通气时间均有显著差异（P<0.05），患者的器官衰竭数量、ICU住院时间及28d病死率无显著差异（P>0.05），但限制性输血组较开放性输血组60d病死率低（P<0.05）。结论采用限制性输血策略，可以在节约输血成本的同时，增加机械通气患者的60d内无机械通气时间，降低60d病死率。
목적：통과대중증의학과（ICU）중빈혈적궤계통기환자실시한제성수혈급개방성수혈，비교량충불동적수혈책략대환자적예후적영향。방법선택2012년6월-2014년6월기간입주아원중증의학과적수궤계통기적빈혈환자120례，수궤분위한제성수혈조（수혈지정Hb≤70g/L；목표Hb71-90g/L)화개방성수혈조(수혈지정Hb≤90g/L；목표Hb91-110g/L)。비교량조적홍세포용량、평균혈홍단백치、궤계통기시간、기관쇠갈수량、ICU주원시간급병사솔。결과량조환자적평균홍세포용량、간예후적Hb평균치이급궤계통기시간균유현저차이（P<0.05），환자적기관쇠갈수량、ICU주원시간급28d병사솔무현저차이（P>0.05），단한제성수혈조교개방성수혈조60d병사솔저（P<0.05）。결론채용한제성수혈책략，가이재절약수혈성본적동시，증가궤계통기환자적60d내무궤계통기시간，강저60d병사솔。
Objective To compare patient outcomes when restrictive or liberal blood transfusion strategies are used to treat anemic critically ill patients requiring mechanical ventilation in ICU. Methods we choose 120 anemic (Hb≤90g/L) critically ill patients requiring mechanical ventilation during 2012.06 to 2014.06 in our department. Patients were randomized to a restrictive (Hb trigger,70g/L;target,71-90g/L) or liberal (90g/L;target,91-110g/L) transfusion strategy for 14 days or the remainder of ICU stay. To compare hemoglobin concentration (Hb),RBC use,and patient outcomes of the two groups. Results There is difference in Hb,RBC use and ventilation-free days during 60d (P<0.05). There is no difference in organ failure,ICU length of stay days and 28d mortality (P>0.05). But the 60d mortality is lower in restrictive transfusion group (P<0.05). Conclusion The ventilation-free days during 60d are longer and 60d mortality is lower when restrictive transfusion strategies are used to treat anemic critically ill patients requiring mechanical ventilation in ICU.