49117名小儿手术患者围术期输血回顾分析

Retrospective analysis of perioperative blood transfusion in 49 117 cases of pediatric surgery

目的为小儿手术围术期临床用血及血液保护提供参考数据。方法提取华西医院手术患者围术期用血资料数据库中1996～2007年12个年度年龄≤14岁患者的资料,回顾性统计分析不同年龄组患儿围术期全血、红细胞悬液、新鲜冰冻血浆的使用情况及其趋势。结果 1996～2007年间,小儿手术围术期平均输血率为11.75%,全血、RBCs、FFP输注比例分别46.40%、32.91%、19.94%,输注率最高为新生儿(39.23%),手术患儿围术期全血、RBCs、FFP平均输注量分别为30±89 ml、0.16±0.81 U、10±89 ml,输血患儿围术期全血、RBCs、FFP平均输注量分别为(261±252)ml、(1.44±2.00)U、(86±252)ml,其中行手术的新生儿围术期全血、RBCs、FFP平均输注量分别为(36±88)ml、(0.33±0.95)U、(39±142)ml,行输血治疗新生儿围术期全血、RBCs、FFP平均输注量分别为(93±121)ml、(0.85±1.37)U、(98±214)ml。结论年龄是评估小儿手术围术期输血的重要指标;新生儿及婴幼儿临床用血应使用合理包装以防止浪费和用血过量。

Object To describe blood use in the perioperative period of pediatric surgery in West China Hospital. Methods Over a 12-year period（ 1996 - 2007）, the hospital operating database was merged with the blood bank database to identify episodes when blood products were transfused in perioperative period. The retrospective statistical analysis of the ex- tracted information of pediatric patients, which is divided into six age groups gives rise to the blood use and trends in whole blood, RBCs, fresh frozen blood. Results Over a period of 12 years,transfusion rate of pediatric surgery in perioperative period was 11.75% with whole blood , RBCs , FFP transfusion ratio of 46.40%, 32.91%, 19.94%, and the highest infusion rate went to newborns （39.23 % ）. Of all children who received surgeries , the average infusion volume of whole blood, RBCs, FFP in perioperative period were （30 ± 89）ml, （0.16 ± 0.81 ） U, （ 10 ± 89 ） ml. Of all children who received blood transfu- sions,the average infusion volume of whole blood, RBCs, FFP in perioperative period were （261 ± 252） ml, （ 1.44 ± 2.00） U, （86 ± 252）ml. The average infusion volume of newborns who received surgeries of whole blood, RBCs, FFP were （36 ± 88） ml, （0.33 ± 0.95 ）U, （39 ±142）ml. The average infusion volume of newborns who received blood transfusions of whole blood, RBCs, FFP were （93± 121 ） ml, （0.85 ± 1.37） U, （98± 214） ml. Conclusion Age is an important index of perioperative blood transfusion in children;We should use reasonable package to prevent waste and excessive use of blood, especially in newborns and infants.