EICU患者医源性贫血与检验失血量的相关性研究  

Correlation analysis between iatrogenic anemia and blood loss for laboratory tests in EICU pafients

作　　者：王兰香[1] 李巨奇[2] 陈尔真[3] 车在前[3] 彭强[1] 冯冬梅[1] 

机构地区：[1]深圳市第五人民医院(罗湖医院)急诊科,广东深圳518001 [2]深圳市第五人民医院中医科 [3]上海交通大学附属瑞金医院急诊ICU,上海200025

出　　处：《中国急救医学》2013年第8期719-722,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨EICU危重患者贫血与检验等医源性失血量及其预后的相关性。方法采用回顾性研究方法，收集两家医院EICU住院危重患者159例，根据性别、年龄、人院时有无贫血、疾病严重程度、是否存活等分组，对贫血、检验失血量、日均检验失血量、APACHEII评分及死亡率等观察指标进行相应比较。结果EICU重症患者贫血发生率高达49．18％，贫血患者死亡率13．84％，显著高于对照组。人院时EICU危重患者合并贫血与APACHE1I评分呈正相关，与检验失血量、日均检验失血量无关。入院后疾病严重程度与贫血、检验失血量差异有统计学意义（P〈0．01）；救治成功率与年龄、APACHEⅡ评分、检验失血量、日均检验失血量等差异也有统计学意义（P〈0．05）。结论EICU重症患者住院期间常合并医源性贫血，这与检验失血量呈正相关，并与疾病严重程度、死亡率的影响明显相关。提高临床医师对检验性失血的重视程度，优化检验流程，采取计划性抽血送检、精确最小检验需血量、剩余血样储存备检及节省血样新式动脉导管等，是降低医源性贫血的有效方法，对提高重症患者救治成功率、降低危重患者死亡率具有极其重要的临床意义。Objective To explore the correlation between anemia and iatrogenic blood loss including blood loss for laboratory tests, and the correlation to prognosis in critically ill EICU patients. Methods This retrospective study included 159 cases of qualified hospitalized cases from two hospitals＂ EICUs. Grouping was done according to gender, age, anemia condition, disease severity, survival respectively, and comparison between the groups was made on anemia, total or average daily blood loss for laboratory tests, APACHE Ⅱ score and mortality, etc. Results Severe anemia rate in EICU patients reached as high as 49. 18%, mortality of anemia patients was 13.84% and was significantly higher than those in the control group. At the time of admission, critically ill EICU patients with anemia correlated positively to APACHE Ⅱ score, but had nothing to do with total and average daily blood loss for laboratory tests. After admission, disease severity significantly correlated with anemia, blood loss for laboratory tests （P 〈0.01 ）. Successful treatment rate was closely related to age, APACHE Ⅱ score, total and average daily blood loss for laboratory tests （ P 〈 0.05）. Conclusion The iatrogenic anemia in critically ill EICU patients is positively correlated with blood loss for diagnostic testing, which significantly affects disease severity and mortality. Clinical doctors should pay more attention to blood loss for diagnostic testing in critically ill EICU patients. An optimized blood testing process, designed blood test plan, minimized blood sample volume, residual blood storage for blood retest and new artery catheter are effective methods to reduce test blood loss and iatrogenic anemia, which has extremely important clinical significance to improve successful treatment rate and reduce the mortality of critically ill patients.

关 键 词：症监护病房(ICU) 急诊 贫血 医源性 危重症 检验 

分 类 号：R92[医药卫生—药学]