先天性心脏病患者实施无血手术策略疗效分析

Efficacy analysis of bloodless surgery in patients with congenital heart disease

目的探讨先天性心脏病患者实施无血手术策略的可行性,以应对血液资源紧张现状,提高临床科学用血水平。方法选择2014年1月至2016年12月期间在本院心胸外科和新生儿科住院治疗的先天性心脏病患者160例,根据患者围手术期用血情况将患者分为无血手术实验组(n=69)和输血治疗对照组(n=91),比较2组患者的基本资料,包括年龄、体重及GCS评分,术前至术后3 d血红蛋白(Hb)、术中至术后3 d胸腔积液引流量、术中体外循环时间、机械通气时间、阻断时间、ICU天数、术后住院天数、总住院天数、再次插管和2次手术指标,以探讨先天性心脏病患者实施无血手术策略的疗效。结果 1)2组患者年龄、体重及GCS评分间差异不具统计学意义(P>0.05);2)2组患者Hb、术中至术后胸腔积液引流量间差异均不具统计学意义(P>0.05);3)2组患者体外循环时间、机械通气时间、阻断时间、再次插管、2次手术和ICU天数间差异亦均不具统计学意义(P>0.05);但无血手术实验组患者术后住院天数和总住院时间明显低于对照组(P<0.05)。结论先天性心脏病患者实施无血手术具有安全性和可行性,并且可一定程度上缩短了患者住院时间,值得在临床手术治疗中推广应用。

Objective To improve the clinical blood level Through explore the feasibility of blood free surgery for congenital heart disease. Methods Collected 160 patients with congenital heart disease during January 2014 to December 2016 in our hospital, patients were divided into bloodless surgery experimental group （ n = 69） and blood transfusion treatment group （n= 91 ） according to perioperative blood use. The basic data which including age, weight and GCS score, preoperative and postoperative hemoglobin（ Hb）, operation and postoperative pleural effusion drainage, intraoperative extracorporeal circulation time, mechanical ventilation time and blocking time, ICU stay, postoperative hospital stay, total hospital stay, reintubation and re-surgery of the two groups were compared. To investigate the effect of the implementation of bloodless surgical strategy for patients with congenital heart disease. Results 1 ） The difference between the two groups in age, body weight and GCS was not statistically significant （P〉0.05） ; 2） The differences of Hb and intraoperative and postoperative pleural effusion drainage between two groups were not statistically significant （P〉0. 05） ; 3） The differences with cardiopul- monary bypass time, mechanical ventilation time, blocking time, re-intubation, re-surgery and ICU days of two groups were also not statistically significant （P 〉 0. 05） ; but bloodless surgery patients＇ postoperative hospitalization days and total hos- pitalization time was significantly lower than the control group （ P〈0. 05）. Conclusion The implementation of bloodless surgery in congenital heart disease is safe and feasible. It can shorten the patient＇s hospitalization time. It is worth popularizing in clinical surgical treatment.