不同输血策略对老年患者输注效果及临床结局的影响

Effect of different transfusion strategies on efficiency of red blood cell transfusion and clinical outcome in elderly patients

目的:探讨老年内科患者的输血阈值水平,评价不同输血策略对老年患者红细胞输注效果及临床结局的影响。方法:回顾性调查2012-03-2014-03老年内科患者的临床输血资料及病历资料,统计分析老年患者的输血阈值水平;根据患者输血前血红蛋白(Hb)水平将患者分为开放性输血组(>60g/L)和限制性输血组(<60g/L),比较分析2组输注效果、病死率、输血不良反应的发生率,院内感染等指标。结果:老年内科患者输血Hb阈值达(63.8±15.1)g/L,限制性输血组输注显效率明显高于开放性输血组(P<0.01),无效及效果不佳的比率明显低于开放组(P<0.01);2组输血不良反应的发生率和住院期间病死率比较差异无统计学意义(P>0.05),院内感染率,住院天数的差异有统计学意义(P<0.01)。结论:限制性输血策略对于提高老年患者的输注效率,减少院内感染率和住院时间有积极意义。

Objective：To investigate the threshold level of blood transfusion in elderly patients in medical department,and study the effect of different transfusion strategies on efficiency of red blood cell transfusion and clinical outcome.Method：We retrospectively reviewed the blood transfusion data and medical records of elder patients in medical department in our hospital from March 2012 to March 2014.The threshold level of red blood cell transfusion in elderly patients was statistically analyzed.The patients were divided into liberal transfusion group and restrictive transfusion group according to the hemoglobin（Hb）levels before transfusion.The differences of efficiency of red blood cell transfusion,mortality,transfusion reaction,nosocomial infection and other indicators between the two groups were analyzed.Result：The Hb threshold level of red blood cell transfusion was（63.8±15.1）g/L.The ratio of excellence in restrictive transfusion group was higher than liberal transfusion group,the ratios of inefficacy and poor effect were both lower than open transfusion group.There were statistically significant differences in nosocomial infection rate and hospital day between the two groups.The difference of incidence of transfusion reaction and mortality between the two groups had no statistical significance.Conclusion：The restrictive transfusion strategy might have positive significance in improving transfusion efficiency in elderly patients,reducing the nosocomial infection rate and hospitalization time.