1996—2007年四川大学华西医院腹部肿瘤手术临床用血回顾  

A retrospective study of blood transfusion in 18310 abdominal tumor surgical cases,from 1996 to 2007

作　　者：吴文知[1] 郑剑桥[1] 熊鹰[1] 张蕾[1] 段泽艳[1] 熊亚琴[1] 张兰[1] 秦莉[2] 刘进[1] 

机构地区：[1]四川大学华西医院麻醉科,四川成都610041 [2]四川大学华西医院输血科,四川成都610041

出　　处：《中国输血杂志》2010年第2期112-115,共4页Chinese Journal of Blood Transfusion

摘　　要：目的通过对18310名腹部肿瘤手术患者临床用血资料的回顾性调查,获得该病种临床用血现状及变化趋势,为加强腹部肿瘤手术血液保护的实施提供数据支持。方法收集1996年1月1日-2007年12月31日在四川大学华西医院实施腹部肿瘤手术的患者18310名,根据输血日期和手术日期计算总体和不同年度的手术例数、输血例数、输血率、输血量和输血时间,输血时间分为术前(T0)、手术当日(T1)、手术后d2(T2)、d3及以后(T3),计算不同年度的肿瘤手术例数、输血例数、输血率、输血量和输血时间。结果腹部肿瘤手术患者RBC、FFP输入例数分别为7229、1609例,输入量分别为6288、1421L;腹部手术例数逐年递增,RBCs输入例数及输入量没有明显的变化,输入率在波动中呈现逐年下降的趋,从1996年的82.59%降至2007年的30.11%;2004年后FFP输入例数、输入量及输入率急剧上升,输入例数2007年较1996年提高16倍,输入量增加37倍,输入率提高9倍,明显高于RBCs的增加幅度。74.38%的RBCs集中在T1时间段输入,FFP主要在T1及T3时间段,分别占总用量的34.73%、47.64%,明显高于T1、T2时间段(P<0.05)。结论在腹部肿瘤手术总量逐年增加的情况下,RBCs输入率却表现出下降的趋势,提示本院血液保护工作初见成效,但FFP滥用的可能性值得关注。Objective To understand the perioperative blood transfusion status and trend of abdominal tumor surgical of 18 310 cases in West China Hospital,and to provide a data support for strengthening blood protection and a further blood transfusion guideline in patients undergoing abdominal tumor surgery.Methods The information of demographic,diagnosis,surgical styles,and blood transfusion in all patients who underwent abdominal tumor surgery from 1996 to 2007 were collected.The time of blood transfusion was defined as pre-（T0）,intra-（T1）,2 d after surgery（T2）,and more than 3 d after surgery（T3）.The blood transfusion rate,amount,and time of patients in different year were analyzed.Results The total blood transfusion amount was about 8 000 L in 12 years,which included 79% Red blood cells（RBCs）and 21% fresh frozen plasma（FFP）.There were 39.84% patients underwent abdominal tumor surgery received RBCs transfusion,and 8.79% patients received FFP transfusion.The RBCs transfusion percentage was high up to 82.59% in 1996,and gradually decreased to 30.11% in 2007（P〈0.05）.The transfusion percentage of FFP was significant increasing from 2.41% in 1996 to 22.8% in 2007（P〈0.05）.After 2004,the percentage and amount of FFP transfusion increased rapidly.Conclusion Nearly 40% abdominal tumor surgical cases received allergenic transfusion perioperatively in 1996—2007 in our hospital.The transfusion of RBCs didn＇t increase with the abdominal tumor surgical cases,which indicated that blood protection has taken effect in our hospital.The use of FFP has trend to increase rapidly after 2004,which suggested that FFP abuse still existed in our hospital,and it is necessary to prompt reasonable use of FFP.

关 键 词：腹部肿瘤手术 输血 回顾 

分 类 号：R457.1[医药卫生—治疗学] R735[医药卫生—临床医学]