贮存式自体血在老年患者中的应用分析

Application of Stored Auto-Transfusion in Elderly Patients in Our Hospital

目的回顾性分析某院老年患者中贮存式自体输血(PABD)的应用,探讨推广PABD的可行性和难点。方法收集2016年1月~2017年12月在本院择期手术行PABD的患者285例的回顾性资料,选择其中年龄大于55岁的老年患者127例为观察组,与同等条件下未实施PABD的老年患者(对照组)进行对比分析,比较两组患者在输血率、输血量、术中出血量、术后血红蛋白(Hb)水平和不良反应上的差异。结果实施和未实施PABD的老年患者的术中输血量和输血率均高于非老年患者(P<0.05)。观察组的老年患者未见输血不良反应,而对照组则有2例,均表现为过敏或发热反应。与对照组相比,观察组患者的术中出血量明显减少,术中输血率及输血量大幅下降,但术后血红蛋白水平较低,差异均有统计学意义(P<0.05)。结论PABD在老年患者中同样有良好的效果,值得推广。

Objective This paper reviews the present situation of application of storage auto-transfusion of Preoperative Autologous Blood Donation(PABD)in our hospital,analyzes its clinical effect in elderly patients,and probes into the feasibility and difficulties of popularizing PABD in elderly patients.Methods Data from285 patients with PABD undergoing elective operation in our hospital from January,2016 to December,2017 was retrospectively analyzed.Among them,127 elderly patients over 55 years old were selected as the observation group and the elderly patients without PABD under the same conditions as the control group.The blood transfusion rate,the blood transfusion volume and the intraoperative bleeding volume,hemoglobin(HB)level and adverse reaction after operation were compared between the two groups.Results The intraoperative blood transfusion volume and blood transfusion rate in the elderly patients with or without PABD were significantly higher than those in the non-elderly patients(P<0.05).There were no adverse reactions in the elderly patients in the observation group,but 2 cases in the control group,both showing allergic or febrile reactions,and the incidence of adverse reactions was 1.5%.Compared with the control group,the intraoperative blood loss,blood transfusion rate and blood transfusion volume decreased significantly in the observation group,but the hemoglobin level was lower after operation(P<0.05).Conclusion PABD also has good effect in elderly patients and is worth popularizing.At the same time,the hospital should establish a scientific and reasonable blood transfusion system to improve conditions for the promotion of PABD.