某院外科手术备血与术中用血分析

Analysis of surgery blood ordering and intra-operative blood preparation in a hospital

目的根据外科手术患者不同部位与疾病,制定外科手术备血策略。方法收集重庆市急救医疗中心2014年1月-2015年12月外科手术患者术前备血和术中用血数据,用SPSS 19.0对其进行分析,比较不同疾病的手术用血率。结果手术总用血率约为42.3%,不同手术部位与疾病患者手术用血率从高到低依次为失血性休克77.3%,颅脑损伤63.2%,心脏疾病56.5%,多发伤55.3%,肝胆损伤46.5%,骨折40.8%,胃肠道疾病39.1%,腹部损伤39.0%,车祸伤38.9%,锐器、钝器伤38.4%,颅内出血36.5%,动脉瘤30.4%,胸部损伤19.7%,食管癌、肺癌10.6%。结论外科手术患者备血,应根据手术部位与疾病、实际用血量和实际用血人数建立外科手术患者手术备血策略:用血百分比<30%的手术,不用备血;≥30%进行交叉配血,实际备血量根据患者具体情况而定,保证临床输血安全、合理、有效。

Objective To investigate the situation of intra-operative blood transfusion, in order to provide a strategy for blood transfusion. Methods All data were collected from Jan 2014 to Dec 2015 and analyzed by SPSS19. 0. Results The intra-operative transfusion rate of patients was 42. 3%. It was demonstrated that the causes of transfusion were due to hemor-rhagic shock （77.3%）, brain injury （ 63.2%）, heart disease （ 56. 5%）, multiple trauma （ 55.3% ）, hepatobiliary injury （46. 5%）, fracture （40. 8%）, gastrointestinal disease （39. 1%）, abdominal injury （39. 0%）, traffic accident injuries （ 38.9% ）, penetrating and blunt trauma （ 38.4% ）, intracranial hemorrhage （ 36. 5% ）, aneurysm （ 30. 4% ）, thoracic injury （ 19. 7% ）, lung carcinoma and esophageal carcinoma （ 10. 6% ）. Conclusion The surgical blood ordering schedule was proposed according to the sites of surgical patients, the actual usage of blood and the amounts of patients. There is no need to order blood when the rate is less than 30%. However, cross-match is needed when the rate is more than 30%, and the actual usage is determined by the conditions of surgical patients. To acquire safe, reasonable and effective blood transfusion, it is important to propose a scientific surgical blood ordering schedule.