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术中限制性输血的临床对比研究
Clinical comparative study of intraoperative restrictive transfusion

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DOI:
作者:
陈炜；孙建良；赵凤庆；陈海炳
CHEN Wei，SUN Jian-liang，ZHAO Feng-qing，CHEN Hai-bi
作者单位:
嘉兴市第一医院
First Hospital of Jiaxing
关键词:
限制性输血；术中；血红蛋白；红细胞比容
restrictive transfusion；intraoperative； hemoglobin； hematocrit
摘要:
[摘要]目的　探讨术中限制性输血在节约用血、合理用血和降低输血相关不良反应的作用。方法　使用便携式床边血气分析仪（i-STAT公司生产）动态监测2010年1-12月在嘉兴市第一医院外科、预计出血量大于400ml的大手术患者术中Hb、Hct值，根据输血分值评估体系采取限制性输血。结果　与开放性输血组相比，限制性输血组（组II）节约悬浮红细胞达32.12％，人均输血量和输血比例及输血相关并发症均低于开放组输血组（组I）(P<0.05)。结论　术中动态测定Hb、Hct，并根据输血分值评估体系评判，是实施限制性输血的有效手段，能有效控制术中不必要的输血，节约血资源，降低输血相关并发症。
[Abstract] Objective: To investigate the effect of restrictive blood transfusion in saving blood, rational use of blood, reducing the incidence of transfusion-related adverse reactions during operation. Method: From January 2010 to December 2010, in First Hospital of Jiaxing, the hemoglobin (Hb) and hematocrit (Hct) of selective operative patients whose blood loss was expected to be more than 400 mL during the procedure, were monitored using a bedside blood gas analyzer (i-STAT). Restrictive transfusion strategy was adopted according to the transfusion score evaluation system. Results: Compared with the liberally transfused group(group I), the amount of red blood cells suspension was reduced by 32.12 percent in the restricted transfusion group(group II). And the average volume of transfusion, ratio of blood transfused and incidence of transfusion-related adverse reactions is lower in the restricted transfusion group as well(P <0.05 ). Conclusion: Monitoring Hb and Hct during operation is an effective measure for implementation of a restrictive transfusion protocol to reducing unnecessary blood transfusions, saving blood and reducing the incidence of transfusion-related adverse reactions during operation.

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