“无输血手术”在心血管外科手术中的疗效观察

Observation on the application of conservative blood management in cardiac surgery

目的探讨"无输血手术"在心血管外科手术的疗效观察,以有效减少异体血液的输注,实现"无输血手术",节约血液资源。方法在本院2010–2011年我院成人心脏手术82例作为实验组,同期65例成人心脏手术作为对照组,分析未输血患者和输血患者术前和术后住院期间Hct、Hb、WBC以及术后住院天数等指标。结果实验组65名患者实现无输血手术(79.27%),实验组和对照组比较,术前血小板(202.6±61.73)×109和(197.4±65.91)×109、Hb(131.6±15.64)g/L和(130.7±16.97)g/L、WBC(4.7±0.86×1012和(4.5±0.67)×1012均无统计学差异。术后d 5,实验组和对照组的Hct(0.37±0.06)和(0.36±0.07)、WBC(3.94±0.49)×1012和(4.05±0.44)×1012,Hb(110.9±12.1)g/L和(116.8±15.2)g/L,P<0.05。实验组术后住院天数明显短于对照组(7.8±1.6)d和(9.5±4.3)d,P<0.05。结论 "无输血手术"在心血管外科手术的应用是有效和可行的,可大量减少成人心脏手术异体血液的输注。

Objective To study the clinical application of blood management in thoracic surgery operation. Methods 147 patients with thoracic surgery operations from 2010 to 2011 were divided into bloodless group （ n = 82 ） and control group （ n = 65 ）. Preoperative and postoperative indicators, including hematocrit, hemoglobin, RBC and postoperative days, were compared in the two groups. Results In the two groups, hematocrit, hemoglobin and RBC before the operation were not statistically significant （P 〈 0.05 ） . The value of hematocrit and RBC in the fifth day after the operation also showed no significant difference in these groups, while the hemoglobin in bloodless group was lower than in control group （ 110. 9 ±12. 1 ） g/ L and （116. 8 ± 15.2）g/L, respectively （P 〈 0. 05 ）. Additionally, postoperative days were shorter in bloodless group than in control group （7.8 ±1.6） d, （9. 5 ±4.3 ）, （ P 〈 0.05 ） . Conclusion Blood management can be safe and feasible without the use of any blood products for thoracic surgery operation. Bloodless surgical treatment could be achieved in 79.3 percent of patients with thoracic surgery operation.