产科输血风险及其对术前备血方案的影响

发布时间：2018-01-14 13:18

本文关键词：产科输血风险及其对术前备血方案的影响　出处：《中国输血杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的分析产科不同病种与围术期输血需求的关系,探讨产科择期手术的术前备血方案,以利于合理安排用血计划。方法回顾上海交通大学医学院附属仁济医院产科2013年1月1日-2017年6月30日收治的16 232名择期手术病例,比较年龄、术前诊断、手术类型、术前备血量、术中用血量、超计划用血量、用血和超计划用血比例等,进行手术用血风险因素分析。结果 455名患者使用了1 610单位红细胞,分别占备血人次的2.80%和备血量的4.87%,151名患者手术中超计划使用了500单位红细胞,分别占用血人次的33.19%和用血量的31.06%,胎盘因素、异位妊娠、胎儿因素占用血人次比和用血量比的前三位,分别为32.32%和59.58%、6.52%和10.30%、5.88%和9.12%,均高于或接近平均值两倍。结论重视产前诊断与产科手术用血风险的关联,对于合理制订用血计划,指导术前血液准备,确保产科手术安全具有重要现实意义。
[Abstract]:Objective to analyze the relationship between different diseases in obstetrics and the need for blood transfusion in perioperative period, and to explore the preoperative blood preparation scheme for elective obstetric surgery. Methods 16232 patients with elective surgery were treated in Renji Hospital, affiliated to Shanghai Jiaotong University Medical College from January 1st 2013 to June 30th 2017. Comparison of age, preoperative diagnosis, type of operation, preoperative blood volume, intraoperative blood volume, excess planned blood volume, proportion of blood use and excess blood use. Results 455 patients were treated with 1 610 units of red blood cells, accounting for 2.80% of the total blood count and 4.87% of the blood volume. 33.19% units of red blood cells and 31.066% of total blood volume were used in 33.19% patients. Placental factors and ectopic pregnancy were observed. The fetal factor occupied the first three places in the ratio of blood to person and blood volume, which were 32.32% and 59.58% and 10.30% 5.88% and 9.12%, respectively. Conclusion it is important to pay attention to the relationship between prenatal diagnosis and the risk of blood use in obstetrical surgery, to make blood use plan reasonably, to guide preoperative blood preparation and to ensure the safety of obstetrical surgery.
【作者单位】：上海交通大学医学院附属仁济医院输血科;
【基金】：上海市公共卫生重点学科建设项目(No.15GWZK0501)
【分类号】：R457.1;R714
【正文快照】： 术前备血不仅是各级医疗机构输血科的常规工作,同时也关系着临床用血安全及血液库存管理优化,特别在血液资源日益紧张的今天,探寻科学合理的手术前备血方案,可以提高工作效率、加快库存周转,既能保证术中用血的及时有效,也能避免不必要的浪费和消耗[1-2]。本文以产科手术的备

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