RICU患者医源性贫血及血液保护策略  

Iatrogenic anemia and blood conservation strategy of patients in RICU

作　　者：庞剑[1] 赵娜[1] 蒋露[1] 曹琳[1] 温慧敏[1] 周淑娟[1] 白丹[1] 刘敏[1] 李丹[1] 铁晓源[1] 庞丽娜[1] 臧燕[1] 顾海彤[1] 

机构地区：[1]首都医科大学附属北京同仁医院呼吸科,100730

出　　处：《中华现代护理杂志》2012年第34期4129-4132,共4页Chinese Journal of Modern Nursing

摘　　要：目的研究RICU患者医源性贫血和诊断性失血的关系，以及优化采血前后RICU患者医源性贫血情况的变化。方法将2011年1月至2012年5月RICU收治的患者符合入选标准者69例纳入研究。其中2011年1—7月符合人选标准的患者37例，设为对照组，按常规采血法采血；2011年8月至2012年5月符合入选标准的患者32例，设为观察组，按减少采血量的优化采血法采血。结果对照组患者入RICU第7天贫血人数23例，显著多于第1天的6例，差异有统计学意义（X2=16．388，P=0．000）；观察组患者入RICU第1天贫血者14例，第7天贫血者19例，差异无统计学意义（X2=1．564，P：0．211）。对照组BLd1-3、BLd4-7、BLd1-7大于观察组，差异有统计学意义（P〈0．05）。观察组Hbc1-3、Hbc1-7均小于对照组，差异有统计学意义（P〈0．05），但Hbc4-7差异无统计学意义（P〉0．05）。结论诊断性失血可造成RICU患者医源性贫血，优化采血方式，加强血液保护可降低医源性贫血的发生率。Objective To investigate the relationship of iatrogenic anemia and diagnosis blood loss for patients in RICU, and the change of the anemia before and after the optimized phlebotomy. Methods A prospective study was performed including 69 patients in RICU who met the inclusion criteria during January 2011 to May 2012. The patients adopted from January 2011 to July 2011 were assigned into control group （n = 37） and from August 2011 to May 2012 were assigned into observation group （n = 32）. The control group received the conventional phlebotomy, while the observation group received optimized blood collection method aimed at reducing the blood loss volume respectively. Results In the control group the number of patients with anemia at the 7th day was more than that of the 1st day （23 vs 6; X2 = 16. 388 ,P =0.000） ; there was difference in Hbal, Hb03, Hba7 （ P 〈 0.05 ） ; the mean daily phlebotomy volume of the first three days was greater than that of the last four days （P =0.000） ; Hbc1-3 and Hbc1-7 were related with BLd1-3 ,Hbc4-7 was related with BLd4-7 （P 〈 0.05 ） ; BLd1-3, BLd4-7, BLd1-7 were related with APACHE Ⅱ score positively （ P 〈 0.05 ）. In observation group there was no difference in the proportion of patients with anemia between the 7th day and the 1st day （ 19 vs 14; X2 = 1. 564,P =0. 211 ）; Hbd1, Hbd3 and Hbd7 were no difference （P 〉0.05）; the average daily blood loss volume of the first three days was greater than that of last four days （P 〈0.05） ; Hbc1-3 ,Hbc4-7, Hbc1-7 were not related with BLd1-3, BLd4-7 and BLd1-7 （ P 〉 0.05 ）. BLd1-3, BLd4-7 and BLd1-7 were unrelated with APACHE 11 scores （P 〉0. 05）. BLd1-3, BLd4-7, BLd1-7, Hbc1-3, Hbc1-7 in the control group were greater than those of the observation group （ P 〈 0. 05 ） ; there was no difference in Hbc4-7 between the two groups （ P 〉 0. 05 ）. Conclusions Diagnostic blood loss can cause the iatrogenic anemia of patients in RICU, and optimizing the blood collection method a

关 键 词：重症监护 医源性贫血 诊断性失血 血液保护 

分 类 号：R472[医药卫生—护理学]