骨折患者的术中输血分析  

Survey of blood transfusion during in operation of fracture sufferers

作　　者：周俊[1] 金玉[1] 张长虹[1] 陈雪[1] 

机构地区：[1]北京军区总医院输血科,北京100700

出　　处：《中国输血杂志》2012年第3期205-206,共2页Chinese Journal of Blood Transfusion

摘　　要：目的为评估各类骨折患者手术备血,为合理保障手术用血提供参考依据。方法对应骨折手术并输血的445名患者进行病例回顾性调查分析,包括不同骨折部位手术的出血量、手术中及手术前后的用血量,术中输血指征的遵循状况等。结果骨折手术输血患者中,髋臼及股骨258例,颈、胸、腰椎72例,小腿及足部56例,上肢(上臂、前臂及手)血49例,分别占57.89%、16.19%、12.58%和11.01%。颈、胸、腰椎部位手术术中出血量最多,平均出血量(881.7±695.9)ml,髋臼及股骨部位的术中出血量最少,平均出血量(378.2±414.7)ml。术中平均输血量与出血的趋势基本一致,髋臼及股骨部位手术的术中和术后输血均相对较少,术中输血22.02%符合术中输血指征。失血量<400 ml和400≤失血量<800 ml的患者平均年龄显著高于失血量≥800 ml,髋臼及股骨部位手术在失血<400 ml的患者中所占比例最高(72.91%)。结论有77.98%输血不符合输血指征,但该部分患者髋臼及股骨部位手术比例较高,且平均年龄较高。Objective In order to value the preparation of blood and ensure transfusion for operation, we Carried on an investigation about blood transfusion during operation of fracture sufferers to provide reference. Methods 445 fracture sufferers who had been operated and transfused blood were investigated, including haemorrhage, blood transfusion and fol- lowing on transfusion indication during operation. Results 1 ）There were 58. 19% patients wounded and 31.88% had re- gressive disease among orthopedics patients who had been operated and blood transfused. There were 445 fracture sufferers, they were 94. 88% percentage of all wounded patients and 55.21% percentage of all orthopedics. 2）There were 258 cases wounded on cotyle or thighbone ,72 cases wounded on spendyle of neck, chest or lumbar, 56 cases on crus and 49 cases on upper limbs. The percentages of fracture sufferers who had been operated and blood transfused were 57. 89%, 16. 19%, 12. 58% and 11.01% respectively. 3 ） The haemorrhage of operation on spondyle was （ 881.7 ±695. 9 ） ml, the cotyle or thighbone was （378.2 ±414.7 ）ml. 4）There were 22. 025 according with the transfusion indication（ bleeding ≥800 ml）during operation. The age of patients which bleed more than 800ml were older than those patients bleed less than 800 ml. Conclusion The transfusion of for 77.98% of fracture sufferers during operation was fallen of transfusion indication. But age of these patients was an important effective factor for transfusion.

关 键 词：输血 骨科手术 骨折 

分 类 号：R457.1[医药卫生—治疗学] R683[医药卫生—临床医学]