【摘要】：目的分析骨科圍手術(shù)期用血情況以及輸血對(duì)術(shù)后病情轉(zhuǎn)歸的影響,以期為骨科圍手術(shù)期科學(xué)合理輸血提供依據(jù)。方法回顧分析2015年10月-2016年9月在骨科接受手術(shù)治療患者圍手術(shù)期用血情況相關(guān)病史資料。結(jié)果共收集骨科手術(shù)患者臨床資料201例,其中未輸血患者為90例,輸血患者為111例(大量輸血組輸注紅細(xì)胞數(shù)量800 m L,17例;非大量輸血組輸注紅細(xì)胞數(shù)量≤800 m L,94例)。輸血組出院前血紅蛋白水平為(103.09±16.37)g/L低于非手術(shù)組(115.79±13.68)g/L,術(shù)后住院時(shí)間輸血組(12.012±8.36 d)高于非輸血組(16.14±10.47d),分析術(shù)后感染情況顯示在未輸血組感染率為1.11%,而輸血組感染率為15.32%,其中在17例大量輸血患者中就有9例發(fā)生了術(shù)后感染(52.94%)。結(jié)論圍手術(shù)期輸血不利于骨科患者術(shù)后血紅蛋白水平恢復(fù),增加術(shù)后感染發(fā)生率延長(zhǎng)住院時(shí)間,因此骨科圍手術(shù)期應(yīng)嚴(yán)格參照輸血指征并加強(qiáng)患者血液管理以降低圍手術(shù)期用血概率,以利于術(shù)后疾病恢復(fù)。
[Abstract]:Objective to analyze the blood use in perioperative period of orthopedic department and the influence of blood transfusion on the prognosis of orthopedic surgery, in order to provide scientific and reasonable blood transfusion basis for orthopaedic surgery. Methods the history of perioperative blood use in patients undergoing orthopedic surgery from October 2015 to September 2016 was retrospectively analyzed. Results 201 cases of orthopedic surgery were collected, including 90 cases without blood transfusion and 111 cases with blood transfusion. The number of red blood cells was less than 800 ml / L in the group of non massive blood transfusion (n = 94). The level of hemoglobin in blood transfusion group was (103.09 鹵16.37) g / L lower than that in non-operative group (115.79 鹵13.68) g / L, and the postoperative hospitalization time in transfusion group was (12.012 鹵8.36) days higher than that in non-transfusion group (16.14 鹵10.47 days). The infection rate was 1.11 in the non-transfusion group and 15.32in the transfusion group. Among the 17 patients with massive blood transfusion, 9 patients had postoperative infection (52.94%). Conclusion Perioperative blood transfusion is not conducive to hemoglobin recovery in orthopedic patients, and increases the incidence of postoperative infection and prolongs hospital stay. Therefore, the perioperative period of orthopedics should strictly refer to the indication of blood transfusion and strengthen the blood management of patients to reduce the probability of blood use in perioperative period, so as to facilitate the recovery of postoperative diseases.
【作者單位】： 復(fù)旦大學(xué)附屬華山醫(yī)院輸血科;
【基金】：國家自然科學(xué)基金面上項(xiàng)目(81570166) 上海市公共衛(wèi)生重點(diǎn)學(xué)科建設(shè)項(xiàng)目(15GWZK0501)
【分類號(hào)】：R457.1;R687

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