多措施节约用血在心脏瓣膜置换手术中的应用

Application of Multiple Measures to Save Blood in Heart Valve Replacement Surgery

目的探讨心脏瓣膜置换手术节约用血措施及对术后并发症、引流量的影响。方法回顾性分析2015年6月-12月、2016年6月-12月行体心脏瓣膜置换手术患者各80例,分别设为对照组(未采取多项措施节约用血)和研究组(采取多项措施节约用血),比较两组术后12h引流量、输血量及术后并发症、术后二次开胸情况。结果采取多项措施节约用血后,研究组患者术后12h引流量、带机时间、ICU时间、术后感染、输血量均低于对照组(P均<0.05),两组术后急性肾功能衰竭、二次开胸及病死率差异无统计学意义(P>0.05)。结论心脏瓣膜置换手术中采用自体血液净化回输、氨甲环酸应用、改良超滤、加强外科止血技术等综合措施可降低术后引流量及用血量,降低术后感染率。

Objective To discuss the effect of postoperative complications and volume of drainage after multiple measures to save blood in heart valve replacement surgery.Methods Since the beginning of 2016,our department has actively adopted the integrated blood saving methods to reduce the amount of blood transfusion in cardiac surgery.A total of 160 patients undergoing extracorporeal circulation heart valve replacement surgery were divided into 2 groups:control group(n=80),from June to December 2015 and test group(n=80),from June to December 2016.The volume of drainage after 12 hours,blood transfusion,postoperative complications,and secondary thoracotomy in two groups was analyzed.Results After taking many measures to save blood,the drainage volume,lead time,ICU time,postoperative infection and blood transfusion in the study group were lower than those in the control group(all P<0.05).There was no significant difference in acute renal failure,secondary thoracotomy and mortality between the two groups(P>0.05).Conclusion A lower rate of drainage,blood transfusion and postoperative infection complications can be realized effectively by applying multiple measures to save blood in heart valve replacement surgery.