库存红细胞对骨科老年患者术后影响的临床研究

Clinical study about the effect of red blood cells on postoperative patients with orthopedics

目的评价输注不同时间库存红细胞对骨科老年患者预后和转归的影响。方法回顾性调查2015年6月-2016月6月实施腰椎手术老年患者的病历和输血资料,共计68例,ASA I^II级,性别不限,年龄60~80岁,根据围术期输注红细胞储存天数,分为新鲜组(储存天数≤14 d)和库存组(储存天数>14 d),统计分析两组患者住院天数、切口愈合时间、ICU转入率、二次输血率和肺部感染发生率等预后指标。结果两组患者人口学基本资料、住院天数、切口愈合时间和ICU转入率无统计学差异(P>0.05);二次输血率和肺部感染发生率的差异有统计学意义(P<0.05)输血量与肺部感染发生率成正相关。结论输注新鲜红细胞悬液能更有效的提高老年骨科手术患者的输注效率,降低输血量和肺部感染的发生率,改善预后与转归。

Objective To evaluate the effect of red blood cells stored for different time on the prognosis and outcome of orthopedic patients. Methods Medical records and blood transfusion data in elderly patients who underwent lumbar surgery from June 2015 to June2016 were retrospectively investigated. A total of 68 cases were collected, and all cases were in Grade ASA I to II. Gender difference of all cases is not limited. All cases were from 60 to 80 years old. According to storage days of red blood cells, All cases were divided into fresh group（Storage days ≤ 14 days） and stock group（storage days 14 days）. The prognosis indexes of two groups was statistically analyzed,such as hospital stay time, incision healing time, ICU transfer rate, secondary blood transfusion rate and pulmonary infection rate.Results There were no significant differences between two groups in basic demographic data, hospitalization time, wound healing time and ICU transfer rate（P〈0.05）; There were statistically significant difference in the second blood transfusion rate and incidence of pulmonary infection（P〈0.05）. the amount of blood transfusion was positively correlated with the incidence of pulmonary infection.Conclusion Infusion of fresh red blood cells can more effectively improve the efficiency of transfusion in elderly patients with orthopedic surgery, reduce the amount of blood transfusion, decrease the incidence of pulmonary infection, and improve the prognosis and outcome.