心脏手术输血方式的探讨

发布时间：2018-01-28 13:03

本文关键词： 自体输血心脏手术用血量血型年龄性别　出处：《中国输血杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的分析探讨本院择期心脏手术患者输血方式及异体血输注量差异,为今后的临床工作提供一定的参考信息。方法搜集本院2016年1月1日-12月31日共计115例获得明确临床诊断的心脏手术患者的临床输血资料,分析其性别、年龄、血型、病种的分布情况,并对其输血方式和各种异体成分血的输注情况进行回顾性的统计分析。结果 115例术中输血的心脏手术患者中,81例患者应用自体输血,方式均为术中回收式,其中76例亦有异体血输注,5例仅输注自体血;34例术中仅输注异体血。术中应用自体输血的患者年龄明显高于无自体输血者,有自体输血者以冠状动脉硬化性心脏病(冠心病)和风湿性心脏瓣膜病(风心病)居多,其手术风险大,多是2种输血方式并用,其中,冠心病手术患者男性明显多于女性;术中没有自体输血的患者多是先天性心脏病(先心病)的儿童,其术中异体血的输注量明显低于老年心脏手术患者。各个血型间平均用血量无显著差异,不同病种间各成分血平均用量可见显著差异。结论心脏手术多数需要施行体外循环,操作时间长,出血量多,因此用血量很大,应根据病种做好术前备血工作,并积极开展自体输血等血液保护措施。
[Abstract]:Objective to analyze the difference of blood transfusion and allogeneic blood transfusion in patients undergoing elective cardiac surgery in our hospital. Methods from January 1st 2016 to December 31st, the clinical blood transfusion data of 115 patients undergoing cardiac surgery with definite clinical diagnosis were collected. The distribution of sex, age, blood type and disease was analyzed. The methods of transfusion and the blood transfusion of various allogeneic components were analyzed retrospectively. Results among 115 patients undergoing cardiac surgery, 81 patients were treated with autologous blood transfusion. Among them 76 cases also had allogeneic blood transfusion and 5 cases only infused autologous blood. Only allogeneic blood was infused in 34 cases. The age of the patients who received autologous blood transfusion during operation was significantly higher than that of the patients without autologous blood transfusion. Patients with autologous blood transfusion mainly had coronary sclerosing heart disease (coronary heart disease) and rheumatic heart valve disease (rheumatic heart disease). The number of male patients with coronary heart disease was significantly higher than that of women. The patients without autologous blood transfusion during operation were mostly children with congenital heart disease (CHD). The volume of allogeneic blood transfusion during operation was significantly lower than that in the elderly patients. There was no significant difference in the average blood consumption among different blood groups. Conclusion Cardiac surgery requires cardiopulmonary bypass (CPB), long operating time and much blood loss. Therefore, the blood volume should be very large, and the preoperative blood preparation should be done well according to the disease species. And actively carry out autotransfusion and other blood protection measures.
【作者单位】：同济大学附属东方医院南院检验科;
【基金】：上海市东方医院重点学科建设项目(YZX-2015-10-2)
【分类号】：R457.1;R654.2
【正文快照】： 输血是临床治疗中不可或缺的重要手段之一,临床输血包括自体输血和异体输血2大类,我们通常所讲的临床输血是指异体输血。随着社会和医学领域对异体输血存在潜在的疾病传播的巨大风险的认识不断深入,以及血液资源严重短缺的局面又难以解决,自体输血的作用和意义凸显重要。自体

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