优化贮存式自体输血采血方案在心脏外科择期手术中的应用  

Evaluation of the optimized schemes for preoperative autologous donation in cardiac elective surgery

作　　者：戴萍[1] 车辑[1] 张卫梅[1] 朱红岩[1] 杨凤梅[1] 

机构地区：[1]首都医科大学附属北京安贞医院,北京100029

出　　处：《中国输血杂志》2014年第2期171-174,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨优化贮存式自体输血采血方案对心脏外科择期手术患者输血效率、并发症及预后的影响．确定该采血方案在心血管外科患者中应用的可行性。方法选择2013年1—5月在本院行心脏外科择期手术的患者100名，心功能Ⅱ一Ⅲ级，术前采用优化贮存式自体输血采血方案进行贮存武自体输血；观察比较患者采血前后、回输前后Hb、Hot变化，并观察术前3d以内采血与3d以上采血对患者术后恢复的影响。结果100名患者共输注自体血41000mL。采血、输血过程中均未出现不良反应，顺利渡过围手术期。自体采血前后、回输前后、出院前血红蛋白浓度、红细胞压积变化均在正常范围。术前天数、ICU天数、术后天数、总住院天数明显减少。100名患者术后均未发生感染。对比术前〈3d及〉3d采血，各恢复指标之间没有统计学差异（P〉0．05）。结论优化贮存式自体输血的采血方案对心脏外科择期手术患者是一种安全科学有效的术前自体备血方案，可缓解血液紧张对择期手术的影响，提高血液制品使用效率和降低心脏外科手术术后并发症发生率，减少患者术后住院时间。Objective： To explore the effects of the optimized schemes for preoperative autologous donation （PAD） on the patients who were undergoing cardiac elective surgery, including transfusion efficiency, complications and post-operative influence. Methods 100 patients undergoing cardiac elective surgery in our hospital were enrolled with NYHA class ]I or m. Before operation,optimized scheme of PAD was adopted. Changes of Hb and Hot values of the patients were observed before and after PAD. Meanwhile, the influence of optimized PAD date on post-operative recovery was examined, namely col- lecting auto-blood within 3 days and over 3 days respectively before operation. Results 100 patients were given a transfu- sion of 41 000 mL auto-blood in total. No adverse reactions were found during the .process of either blood collection or blood transfusion, and everything went well during the whole peri-operative period. The patients＇Hb and Her values were all within the normal scope before and after PAD, before and after PAD, and before their being discharged from the hospital. None of the 100 cases got infected after operation. The contrast analysis between PAD within 3 days and over 3 days respectively be- fore operation showed that, there was no significant difference among all the recovery indicators （ P 〉 0. 05 ）. Conclusion For patients undergoing cardiac elective surgery, the optimized PAD scheme is a safe, scientific and effective one for cardiac elective surgery patients. It can reduce the influence of blood shortage on elective surgery, enhance the efficiency of blood products,decrease cardiac surgical post-operative complications in frequency, and shorten the time of post-operative hospi- talization.

关 键 词：自体输血 优化贮存式采血方案 心脏外科 择期手术 

分 类 号：R457.1[医药卫生—治疗学] R654.2[医药卫生—临床医学]