中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2015年
24期
1-3
,共3页
钟标%魏崴%李勇生%黎佩建
鐘標%魏崴%李勇生%黎珮建
종표%위외%리용생%려패건
体外循环%心脏手术%血液保护%输血
體外循環%心髒手術%血液保護%輸血
체외순배%심장수술%혈액보호%수혈
Cardiopulmonary bypass%Cardiac surgery%Blood conservation%Blood transfusion
目的 评价以血红蛋白(Hb)<90 g/L作为体外循环心脏手术术后输血标准的效果.方法 2011~2014年入组择期体外循环心脏手术患者201例作为限制组, 2008~2010年手术中符合入组标准的163例患者作为常规组.在采取多项血液保护措施的基础上, 限制组以血红蛋白<90 g/L作为术后输血标准, 常规组以血红蛋白<100 g/L为标准, 回顾性比较两组患者输血情况及术后转归情况.结果 限制组红细胞输注率为55.7%, 用量为(1.9±2.0)U, 均较常规组的92.0%、(5.2±2.5)U降低(P<0.01), 限制组新鲜冰冻血浆平均用量较常规组亦有降低[(360.1±221.2)ml VS (605.2±200.6)ml,P<0.01], 血小板输注率两组比较差异无统计学意义(10.9% VS 10.4%,P>0.05).两组患者ICU停留时间、死亡率比较差异无统计学意义(P>0.05), 限制组手术后住院时间较常规组短(P<0.05).结论 非重症患者体外循环心脏术后以血红蛋白<90 g/L作为输血标准, 减少了输血率和输血量, 不影响手术疗效, 节省了大量的血液资源.
目的 評價以血紅蛋白(Hb)<90 g/L作為體外循環心髒手術術後輸血標準的效果.方法 2011~2014年入組擇期體外循環心髒手術患者201例作為限製組, 2008~2010年手術中符閤入組標準的163例患者作為常規組.在採取多項血液保護措施的基礎上, 限製組以血紅蛋白<90 g/L作為術後輸血標準, 常規組以血紅蛋白<100 g/L為標準, 迴顧性比較兩組患者輸血情況及術後轉歸情況.結果 限製組紅細胞輸註率為55.7%, 用量為(1.9±2.0)U, 均較常規組的92.0%、(5.2±2.5)U降低(P<0.01), 限製組新鮮冰凍血漿平均用量較常規組亦有降低[(360.1±221.2)ml VS (605.2±200.6)ml,P<0.01], 血小闆輸註率兩組比較差異無統計學意義(10.9% VS 10.4%,P>0.05).兩組患者ICU停留時間、死亡率比較差異無統計學意義(P>0.05), 限製組手術後住院時間較常規組短(P<0.05).結論 非重癥患者體外循環心髒術後以血紅蛋白<90 g/L作為輸血標準, 減少瞭輸血率和輸血量, 不影響手術療效, 節省瞭大量的血液資源.
목적 평개이혈홍단백(Hb)<90 g/L작위체외순배심장수술술후수혈표준적효과.방법 2011~2014년입조택기체외순배심장수술환자201례작위한제조, 2008~2010년수술중부합입조표준적163례환자작위상규조.재채취다항혈액보호조시적기출상, 한제조이혈홍단백<90 g/L작위술후수혈표준, 상규조이혈홍단백<100 g/L위표준, 회고성비교량조환자수혈정황급술후전귀정황.결과 한제조홍세포수주솔위55.7%, 용량위(1.9±2.0)U, 균교상규조적92.0%、(5.2±2.5)U강저(P<0.01), 한제조신선빙동혈장평균용량교상규조역유강저[(360.1±221.2)ml VS (605.2±200.6)ml,P<0.01], 혈소판수주솔량조비교차이무통계학의의(10.9% VS 10.4%,P>0.05).량조환자ICU정류시간、사망솔비교차이무통계학의의(P>0.05), 한제조수술후주원시간교상규조단(P<0.05).결론 비중증환자체외순배심장술후이혈홍단백<90 g/L작위수혈표준, 감소료수혈솔화수혈량, 불영향수술료효, 절성료대량적혈액자원.
Objective To evaluate effect of blood transfusion standard as hemoglobin (Hb) <90 g/L after cardiopulmonary bypass cardiac surgery.Methods There were 201 patients receiving cardiopulmonary bypass cardiac surgery during 2011~2014 as limited group, and another 163 patients meeting selection standard during 2008~2010 as conventional group. On the basis of applying multiple blood conservation measures, the limited group took hemoglobin <90 g/L as the postoperative blood transfusion standard, while the conventional group took its standard as hemoglobin <100 g/L. A retrospective comparison was made on blood transfusion condition and postoperative outcomes between the two groups.Results The limited group had all lower cell transfusion rate as 55.7% and dosage as (1.9±2.0)U than 92.0% and (5.2±2.5) U in the conventional group (P<0.01). The limited group also had lower average dosage of fresh frozen plasma than the conventional group [(360.1±221.2)ml VS (605.2±200.6)ml,P<0.01]. There was no statistically significant difference of platelet transfusion rate between the two groups (10.9% VS 10.4%,P>0.05). Mortality of the two groups in ICU stay had no statistically significant difference (P>0.05), and the limited group had shorter postoperative hospital stay than the conventional group (P<0.05).Conclusion Implement of hemoglobin <90 g/L as the blood transfusion standard after cardiopulmonary bypass cardiac surgery for non-severe patients can reduce blood transfusion rate and dosage and save a large amount of blood resources, without any influence on curative effect by surgery.
