贮存式自体血利用率影响因素分析

Clinical Study: analysis of the factors in the efficiency of preoperative autologous blood donation

目的分析影响择期手术患者贮存式自体血利用率的因素,探讨其在择期手术贮存式自体血采集中的指导意义。方法 2013年1-11月对本院106名贮存式自体输血(PABD)患者和97名未备自体血患者贮存式自体血的利用进行回顾性分析,分析术前Hb水平、术中预计出血量、自体血回输率、异体血输注及人均输血量等,对PABD的利用效率进行分析讨论。结果 106名PABD患者中有101例(95.3%)自体血得以回输,其中77例患者(72.6%)术中仅输注自体血,26例(24.5%)因术中出血较多而又输注异体血;5例(4.7%)自体血未回输。当患者术前Hb水平>125 g/L时,术中实际出血量<800 m L时,PABD组总的输血率和输血量均大于对照组(P<0.05);出血量>800 m L时,2组患者总输血量没有差异,与术前Hb水平无关。结论患者术前Hb水平较高且术中出血量较少时,实施PABD增加了总的输血量和自体血的报废率,对异体血的节约作用有限。

Objective To analyze the factors that affect the efficiency of preoperative autologous blood donation and to discuss its significance to guide autologous blood collection. Methods A retrospective analysis was conducted on autologous blood donors （ PABD; n = 106） and nondonors （ NPABD; n = 97） in our hospital between January and November 2013. The initial level of hemoglobin （Hb）, mount of blood loss in surgery, autologous blood transfusion and allogeneic blood transfu- sion were analyzed to evaluate the efficiency of transfusion between the two groups. Results One hundred and one patients （95. 3 percent） required autologous blood transfusion. Seventy-seven patients （72. 6 percent） received autologous blood on- ly; twenty-six patients （24. 5 percent） received both autologous and allogeneic blood due to higher amount of blood loss in surgery. 4. 7% （collected from five patients） of autologous blood were discarded. When the initial level of hemoglobin was higher than 125 g/L and the blood loss was less than 800 mL, PABD had a higher transfusion ratio and received more blood transfusion than NPABD （P 〈 0. 05）. There was no significant difference in the rates of blood transfusion between the two groups when the blood loss exceed 800 mL. Results had no correlation with initial hemoglobin levels. Conclusion The effi- ciency of collection of autologous blood is low when patients have a higher level of initial hemoglobin and a minimal risk of blood loss. Patients who have a lower initial hemoglobin level or a blood loss of more than 800 mL experience an optimal uti- hzation of autologous and allogeneic blood.