急诊手术患者围术期临床用血客观指标对比及变化趋势分析

Comparison and analysis of the objective indicators and changing trend for perioperative clinical blood transfusion in patients with emergency operation

目的对比分析急诊手术患者围术期临床用血客观指标及变化趋势,为完善和改进血液保护体系提供循证医学理论支持。方法按三个时间段即2013年1~12月(T1)、2014年1~12月(T2)和2015年1~12月(T3)回顾统计2013年1月至2015年12月我院急诊手术患者各血液成分使用情况和临床输血信息基础数据,使用"麦迪斯顿手术麻醉信息化管理系统"对相关数据进行整合并对比分析其变化趋势。结果与T1比较,T2、T3的红细胞输血率、血浆输注率明显降低(P<0.05),T3的自体血输注率明显升高(P<0.05);与T2比较,T3的红细胞输血率、血浆输注率明显降低(P<0.05);各期急诊手术输血患者各血液成分人均用量组间比较无统计学差异。结论红细胞、血浆输注率逐年下降;术中自体血回收率逐年上升;红细胞、血浆人均输注量无明显变化。

Objective To compare and analyze the objective indicators and changing trend for perioperative clinical blood transfusion in patients with emergency operation and further provide evidence -based theoretical support for the improvement of blood protection system. Methods A retrospective review for the usage of blood components and clinical basic data of blood transfusion in patients with emergency operation from January,2013 to December,2015 had been done with the MEDICALSYSTEM informationization management system of anesthesia （T1：2013. 1 - 12; T2：2014. 1 - 12; T3：2015. 1 - 12）. Results Compared with TI, Rates of red blood cell transfusion and plasma transfusion in T2 and T3 were obviously reduced （P 〈 0.05 ） , while the rate of autologous blood transfusion in T3 was significantly increased （ P 〈 0.05 ）. There was no statistical difference among the per capita dosage of the blood components in the patients with emergency surgery. Conclusion Rates of red blood cell transfusion and plasma transfusion exhibits a downward trend and intraoperative autologous blood transfusion rate shows a upward trend, whereas red blood cell and plasma per capita transfusion has no significant changes.