688例创伤手术病例用血分析

Analysis of blood transfusion in 688 traumatic cases

目的 分析临床输血标准和成分血的使用。方法 收集 1 996、1 998、2 0 0 0年收治的 6 88例创伤失血和择期手术用血病人的临床资料 ,从中选择血液检验结果齐全的 30 8例 ,按血红蛋白 (Hb) <90g/L为A组 (1 0 6例 ) ,Hb >90g/L为B组 (2 0 2例 ) ,作统计学分析。结果 总用血量 81 2 6 94ml,其中红细胞 (RBC)制品2 85 36 8ml。A、B两组Hb值术前和术后 7天分别为 72g/L、92g/L与 1 2 4g/L、1 1 1g/L(P <0 .0 1 )。 1 998年以后用血量显著下降 ,B组更明显 ;成分输血比例 2 0 0 0年达 73%以上。结论 关于输血参考标准 ,对无并发症者 ,应维持Hb 80g/L以上 ,对患有脑、心、肺疾病者 ,维持Hb 80～ 1 0 0g/L以上 ,以保证供氧。

Objective To analyse blood transfusion standard and blood components transfusion in clinical application. Methods 688 cases of traumatic victims and selective operations in the year of 1996,1998,2000 were selected,and 308 cases had complete blood examination data. They were divided into group A and group B. Patients with Hb<90g/L were put into group A(106 cases),and Hb>90g/L into group B(202 cases). Results Total volme of blood used were 812 694 ml,including 285 368ml of RBC products.Preoperative and postoperative 7d,hemoglobin value was found to be 72g/L,92g/L and 124g/L,111g/L in group A and B respectively(P<0.01). Since 1998,volume of blood transfusion has decreased,it is lower in group B than that of in group A. Rate of component blood transfusion has increased by 73% in the year of 2000. Conclusion About reference standard of blood transfusion,recommended hemoglobin level should be kept above 80g/L for patient without complications; for the patients with injuries of cerebrum,heart and/or lungs,hemoglobin level should be kept above 80-100g/L for assurance of oxygen supply to these patients. The rate of component blood transfusion rose year by year.