先天性心脏病患者实施无血手术策略疗效分析

发布时间：2018-03-26 22:03

  本文选题：先天性心脏病　切入点：无血手术治疗　出处：《中国输血杂志》2017年07期

【摘要】：目的探讨先天性心脏病患者实施无血手术策略的可行性,以应对血液资源紧张现状,提高临床科学用血水平。方法选择2014年1月至2016年12月期间在本院心胸外科和新生儿科住院治疗的先天性心脏病患者160例,根据患者围手术期用血情况将患者分为无血手术实验组(n=69)和输血治疗对照组(n=91),比较2组患者的基本资料,包括年龄、体重及GCS评分,术前至术后3 d血红蛋白(Hb)、术中至术后3 d胸腔积液引流量、术中体外循环时间、机械通气时间、阻断时间、ICU天数、术后住院天数、总住院天数、再次插管和2次手术指标,以探讨先天性心脏病患者实施无血手术策略的疗效。结果 1)2组患者年龄、体重及GCS评分间差异不具统计学意义(P0.05);2)2组患者Hb、术中至术后胸腔积液引流量间差异均不具统计学意义(P0.05);3)2组患者体外循环时间、机械通气时间、阻断时间、再次插管、2次手术和ICU天数间差异亦均不具统计学意义(P0.05);但无血手术实验组患者术后住院天数和总住院时间明显低于对照组(P0.05)。结论先天性心脏病患者实施无血手术具有安全性和可行性,并且可一定程度上缩短了患者住院时间,值得在临床手术治疗中推广应用。
[Abstract]:Objective to explore the feasibility of blood free operation in patients with congenital heart disease, and to deal with the current situation of blood shortage. Methods 160 patients with congenital heart disease who were hospitalized in cardiothoracic surgery and pediatrics from January 2014 to December 2016 were selected. The patients were divided into two groups according to their blood use in perioperative period. The patients were divided into two groups: the experimental group without blood and the control group with blood transfusion. The basic data of the two groups were compared, including age, weight and GCS score. From 3 days to 3 days after operation, hemoglobin was used to drain the pleural effusion, time of extracorporeal circulation, time of mechanical ventilation, time of blocking ICU, days of hospitalization after operation, days of total hospitalization, re-intubation and two operations. To investigate the effect of blood free operation in patients with congenital heart disease. There was no significant difference in body weight and GCS score between two groups. There was no significant difference between operation and postoperative pleural effusion drainage flow. There was no significant difference in cardiopulmonary bypass time, mechanical ventilation time and blocking time between operation and postoperative pleural effusion drainage. There was no significant difference between the days of re-intubation and ICU, but the days of hospitalization and total hospital stay in the experimental group were significantly lower than those in the control group. Conclusion the patients with congenital heart disease have no blood hand. The procedure is safe and feasible. And it can shorten the hospitalization time to some extent, which is worth popularizing in the clinical operation treatment.
【作者单位】： 南昌大学第一附属医院输血科;
【基金】：江西省科技重大项目(20144BBG70001)
【分类号】：R457.1;R726.5
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本文编号：1669765