本文選題：腰椎管狹窄減壓術(shù) + 圍手術(shù)期輸血　； 參考：《中國(guó)輸血雜志》2016年09期

【摘要】：目的探討腰椎管狹窄減壓術(shù)圍手術(shù)期輸血的影響因素,明確輸血種類和輸血量的范圍,制定科學(xué)的干預(yù)措施,為建立腰椎管狹窄減壓術(shù)圍手術(shù)期輸血的評(píng)價(jià)模式提供依據(jù)。方法選取大連地區(qū)3家三級(jí)甲等醫(yī)院接受腰椎管狹窄減壓術(shù)患者386例,根據(jù)是否輸注異體血分為輸血組(139例)和未輸血組(247例);根據(jù)患者的輸血量將輸血組分為≤4U組和4U組;根據(jù)輸血方式分為異體輸血組,自體輸血組和(自體+異體)輸血組。收集386例腰椎管狹窄減壓術(shù)患者的基本信息(性別、年齡、臨床診斷)、手術(shù)相關(guān)信息(手術(shù)時(shí)間、術(shù)中失血量)、血常規(guī)(包括術(shù)前、術(shù)中、術(shù)后)、凝血功能指標(biāo)(包括術(shù)前、術(shù)中、術(shù)后)、患者轉(zhuǎn)歸情況(抗生素使用情況、住院天數(shù)、切口愈合情況)以及圍術(shù)期輸血種類和輸血量,并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果腰椎管狹窄減壓術(shù)患者圍手術(shù)期輸血比例為36.01%,患者平均用血量(4.9±2.95)U。輸血組和未輸血組在年齡、手術(shù)時(shí)間、術(shù)中失血量、術(shù)前Hb、住院天數(shù)方面具有顯著性差異,P0.05。輸血組中≤4 U組和4 U組在手術(shù)時(shí)間和術(shù)中失血量方面具有顯著性差異,P0.05。異體輸血組和自體輸血組在抗生素使用種類方面有顯著性差異,P0.05;異體輸血組、(自體+異體)輸血組、自體輸血組在其他轉(zhuǎn)歸情況上無(wú)顯著性差異,P0.05�；颊咝g(shù)中輸血量與術(shù)中失血量、手術(shù)時(shí)間和術(shù)前血紅蛋白濃度的相關(guān)系數(shù)分別為0.001、0.176、-0.163,呈相關(guān)性(P0.05)。結(jié)論對(duì)腰椎管狹窄減壓術(shù)圍手術(shù)期輸血的影響因素有術(shù)中失血量、手術(shù)時(shí)間和術(shù)前患者Hb,自體輸血組、異體輸血組和(自體+異體)輸血組在對(duì)患者術(shù)后轉(zhuǎn)歸方面基本上無(wú)統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective to investigate the influencing factors of perioperative blood transfusion in lumbar spinal stenosis decompression, determine the blood transfusion types and the scope of blood transfusion, and formulate scientific intervention measures to provide the basis for establishing the evaluation model of perioperative blood transfusion for lumbar spinal stenosis decompression. Methods 386 patients undergoing lumbar spinal stenosis decompression in 3 Grade 3A hospitals in Dalian were divided into transfusion group (139 cases) and non-transfusion group (247 cases) according to whether allogeneic blood was infused, the transfusion group was divided into 鈮，

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