围术期血液管理减少心脏外科手术中输血

Investigation about perioperative blood management to reduce the amount of blood transfusion in cardiac surgery

目的回顾性分析围术期血液管理应用于心脏外科手术中减少输血的临床效果。方法本研究为回顾性研究,烟台毓璜顶医院2015年7月至2016年5月和2016年8月至2017年4月接受开胸心脏手术的患者106例,2015年7月至2016年5月的患者为对照组(n=49),采用常规管理;2016年8月—2017年4月的患者为研究组(n=57),采用围术期血液管理。比较两组术前基本信息、术中出血量和输血量,评估应用围术期血液管理的临床效果。结果两组术前红细胞、血红蛋白、血小板水平差异无统计学意义。研究组术中出血量明显少于对照组[(565.8±178.6)ml vs(734.1±278.7)ml,P<0.05];研究组输异体红细胞比例明显低于对照组(1.8%vs 28.6%,P<0.05);研究组输血浆比例明显低于对照组(10.5%vs 40.8%,P<0.05);两组血小板和冷沉淀使用比例差异无统计学意义。结论围术期血液管理应用于心脏外科手术可以有效减少术中出血量,降低异体红细胞和血浆使用率。

Objective To explore the clinical effect of perioperative blood management reduces transfusion in cardiac surgery.Methods A total of 106 patients,who underwent cardiac surgery in Yantai Yuhuangding Hospital from July 2015 to May 2016 and August 2016 to April 2017,were enrolled and divided into two groups.Control group included 49 patients undergoing routine procedures during July 2015 to May 2016（n =49）,while study group included 57 patients receiving perioperative blood management from August 2016 to April 2017（n = 57）.The amount of intraoperative blood loss and transfusion of the two groups was compared and the clinical effect of perioperative blood management was evaluated.Results There were no significant differences between the control group and the study group in preoperative red blood cells,preoperative hemoglobin and preoperative platelet level.Blood loss in the study group was significantly lower than that in the control group[（565.8± 178.6）ml vs（734.1± 278.7）ml,P〈0.05].Red blood cells transfusion rate in the study group was significantly lower than that in the control group（1.8% vs 28.6%,P〈0.05）.Plasma transfusion rate in the study group was significantly lower than that in the control group（10.5% vs 40.8%,P〈0.05）.There were not significant differences in the platelet transfusion rate and the cold deposition transfusion rate.Conclusion The application of perioperative blood management in cardiac surgery can effectively reduce the amount of intraoperative blood loss,and decrease the red blood cells and plasma transfusion rate.