CAJ | 학술논문

目的：联合国内20家大型综合医院多中心回顾性调研外科住院患者大量输血病例1601例，分析探讨不同科室输血情况与患者死亡率的关联性。方法联合全国20家三级综合医院进行多中心回顾性分析不同科室输血情况，根据24h内不同科室用血情况分为：创伤科、心外科、外科、产科，大量输血四类不同科别患者住院期间死亡时间有一定差异，总体合计后死亡率有一定差异。结果24h内输注红细胞≥10U时，四类科室患者的死亡率顺序为：心脏外科(18.4%)>创伤科室(14.4%)>产科(5.7%)>普通外科(5.4%)；24h内输注红细胞<10U时，死亡率顺序为：创伤科室(8.6%)>普通外科(3.9%)>心脏外科(3.4%)>产科。结论不同科室的病种特征不同，其基线数据如输血前患者的性别、年龄、体重、手术时间、血常规及血凝指标等均具有明显差异，我们在制定大量输血方案时，尽可能对心脏外科和创伤患者制定相对独立的输血方案，更进一步减少死亡率。
목적：연합국내20가대형종합의원다중심회고성조연외과주원환자대량수혈병례1601례，분석탐토불동과실수혈정황여환자사망솔적관련성。방법연합전국20가삼급종합의원진행다중심회고성분석불동과실수혈정황，근거24h내불동과실용혈정황분위：창상과、심외과、외과、산과，대량수혈사류불동과별환자주원기간사망시간유일정차이，총체합계후사망솔유일정차이。결과24h내수주홍세포≥10U시，사류과실환자적사망솔순서위：심장외과(18.4%)>창상과실(14.4%)>산과(5.7%)>보통외과(5.4%)；24h내수주홍세포<10U시，사망솔순서위：창상과실(8.6%)>보통외과(3.9%)>심장외과(3.4%)>산과。결론불동과실적병충특정불동，기기선수거여수혈전환자적성별、년령、체중、수술시간、혈상규급혈응지표등균구유명현차이，아문재제정대량수혈방안시，진가능대심장외과화창상환자제정상대독립적수혈방안，경진일보감소사망솔。
Objective To joint 20 large-scale general hospital in domestic and conduct multi-center retrospective analysis about 1601 cases of massive blood transfusion in surgical inpatients, and analyze the relationship between the blood transfusion in different departments and the mortality of patients. Methods Unite China 20 tertiary general hospital and conduct multi- center retrospective analysis of blood transfusion in different departments, According to the usage of blood within 24 hours ,different sec-tions were divided into department of trauma, cardiac surgery, surgery, obstetrics. The death of time after massive blood transfusion in the four departments had a certain difference during hospitalization, and the overall total mortality rate had certain differences, Results When the transfusion of red blood cells ≥ 10U within 24 hours, the mortality order in the four departments as follows:cardiac surgery (18.4%)>trauma department (14.4%)>obstetric (5.7%)>General Surgery (5.4%); When the transfusion of red blood cells <10U within 24 hours, mortality sequence as follows: trauma department (8.6%)>General Surgery (3.9%)>cardiac surgery (3.4%)>obstetrics. Conclusion There existed different disease characteristics in different clinical department. The basic data of patients before blood transfusion, such as gender, age, weight, operation time, blood routine and blood clotting index, had obvious difference. When making plan for massive blood transfusion, we need to develop a relatively independent blood transfusion pro-gram as far as possible for patients in the department of cardiac surgery and trauma, so as to further reduce the mortality.