围手术期输血对骨科患者术后转归的影响

发布时间：2018-11-06 07:27

【摘要】：目的分析骨科围手术期用血情况以及输血对术后病情转归的影响,以期为骨科围手术期科学合理输血提供依据。方法回顾分析2015年10月-2016年9月在骨科接受手术治疗患者围手术期用血情况相关病史资料。结果共收集骨科手术患者临床资料201例,其中未输血患者为90例,输血患者为111例(大量输血组输注红细胞数量800 m L,17例;非大量输血组输注红细胞数量≤800 m L,94例)。输血组出院前血红蛋白水平为(103.09±16.37)g/L低于非手术组(115.79±13.68)g/L,术后住院时间输血组(12.012±8.36 d)高于非输血组(16.14±10.47d),分析术后感染情况显示在未输血组感染率为1.11%,而输血组感染率为15.32%,其中在17例大量输血患者中就有9例发生了术后感染(52.94%)。结论围手术期输血不利于骨科患者术后血红蛋白水平恢复,增加术后感染发生率延长住院时间,因此骨科围手术期应严格参照输血指征并加强患者血液管理以降低围手术期用血概率,以利于术后疾病恢复。
[Abstract]:Objective to analyze the blood use in perioperative period of orthopedic department and the influence of blood transfusion on the prognosis of orthopedic surgery, in order to provide scientific and reasonable blood transfusion basis for orthopaedic surgery. Methods the history of perioperative blood use in patients undergoing orthopedic surgery from October 2015 to September 2016 was retrospectively analyzed. Results 201 cases of orthopedic surgery were collected, including 90 cases without blood transfusion and 111 cases with blood transfusion. The number of red blood cells was less than 800 ml / L in the group of non massive blood transfusion (n = 94). The level of hemoglobin in blood transfusion group was (103.09 卤16.37) g / L lower than that in non-operative group (115.79 卤13.68) g / L, and the postoperative hospitalization time in transfusion group was (12.012 卤8.36) days higher than that in non-transfusion group (16.14 卤10.47 days). The infection rate was 1.11 in the non-transfusion group and 15.32in the transfusion group. Among the 17 patients with massive blood transfusion, 9 patients had postoperative infection (52.94%). Conclusion Perioperative blood transfusion is not conducive to hemoglobin recovery in orthopedic patients, and increases the incidence of postoperative infection and prolongs hospital stay. Therefore, the perioperative period of orthopedics should strictly refer to the indication of blood transfusion and strengthen the blood management of patients to reduce the probability of blood use in perioperative period, so as to facilitate the recovery of postoperative diseases.
【作者单位】：复旦大学附属华山医院输血科;
【基金】：国家自然科学基金面上项目(81570166) 上海市公共卫生重点学科建设项目(15GWZK0501)
【分类号】：R457.1;R687

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