急诊输血指征评分对产科急诊手术输血的影响

Effect of the Score of Indications for Emergency Blood Transfusion on Blood Transfusion in Emergency Obstetric Surgery

目的分析东营市垦利区垦利街道办事处社区卫生服务中心急诊输血指征评分(Emergency TransfusionScore,ETS)系统实施前后产科急诊手术患者的输血情况。方法查阅2022年1月至2023年12月东营市垦利区社区卫生服务中心麦迪斯顿DoCare手术麻醉系统内,产科急诊手术者的基础资料、麻醉记录以及输血信息。根据不同时间段内评分系统的不同,分为ETS组和非ETS组。回顾性分析两组患者的输血结果。结果在采取EST评分实施前后,急诊患者的年龄、性别、体质量指数、美国麻醉师协会(American Society of Anesthesiologists,ASA)分级、输液量均无显著差异(P>0.05)。EST评分前,产科急诊输血患者72例(12.31%),EST评分后,产科急诊输血患者58例(9.45%)。进一步分析显示,ETS评分实施后,红细胞输注率无显著变化(P>0.05),但显著降低了高龄产妇红细胞输注率(P<0.05)、ASA为I~II级患者的红细胞输注率(P<0.05)以及术中红细胞的输注量(P<0.05)。结论ETS评分系统的使用有效降低了产科急诊手术中输血的不合理性,显著改善了输血的效能。

Objective To analyze the blood transfusion details for obstetric emergency surgery patients before and after the implementation of the Emergency Transfusion Score(ETS)system in our hospital.Methods Basic information,anesthesia records,and transfusion information data of obstetric emergency surgery patients treated at Dongying Kenli District Community Health Service Center's MedistoneDo Care Anesthesia System from January 2022 to December 2023 were analyzed.Patients were divided into ETS and non-ETS groups based on the implementation of the scoring system.A retrospective analysis was conducted on the transfusion patterns in both groups.Results Before and after the implementation of the ETS,there were no significant differences in the age,gender,body mass index,ASA classification,or fluid volume of emergency patients(P>0.05).Prior to ETS implementation,72 obstetric emergency patients received blood transfusions(12.31%);post-implementation,this number decreased to 58 patients(9.45%).Further analysis revealed that while the overall red blood cell(RBC)transfusion rate remained unchanged(P>0.05),there was a significant reduction in the RBC transfusion rate among older mothers after ETS(P<0.05),as well as among patients classified as ASA I-II(P<0.05),alongside a decrease in intraoperative RBC volume transfused(P<0.05).Conclusion The implementation of the ETS system effectively reduced the irrationality of transfusions in obstetric emergency surgeries and significantly improved transfusion efficacy.