围术期输血指征评分方案在妇科手术中的应用  

Perioperative transfusion trigger score project used in gynecological operation

作　　者：谢本发 方卫平[1] 朱燕[1] 

机构地区：[1]安徽医科大学第一附属医院麻醉科,合肥230022

出　　处：《安徽医科大学学报》2016年第1期126-129,共4页Acta Universitatis Medicinalis Anhui

基　　金：2010年度卫生部公益性行业科研专项基金项目(编号:3101005002154)

摘　　要：目的 评价围术期输血指征评分（POTTS）在血红蛋白（Hb）值为60~100g/L妇科手术中的应用。方法 选取围术期Hb值为60~100g/L妇科择期手术114例,随机分为围术期输血指征评分（POTTS）组（n=57）：POTTS值决定输血的Hb值;对照组（n=57）：医师决定输血的Hb值。观察比较输入红细胞悬液比例及输入量、死亡率和严重并发症的发生率、ICU入住率、术后Hb恢复、手术切口愈合、住院时间、输血相关费用和住院费用。结果 POTTS组患者围术期输血占组人次比显著低于对照组（P〈0.01）;POTTS组围术期输血量显著低于对照组（P〈0.01）;POTTS组围术期输血费用显著少于对照组（P〈0.01）;两组住院时间、术后拆线时间、切口愈合分级、术后Hb恢复情况、住院费用比较差异均无统计学意义;两组均无入住ICU者、严重并发症和死亡病例。结论 POTTS指导输血方案应用于妇科围手术期Hb值为60~100g/L患者,能够降低输血人次比,减少围术期输血,降低输血费用,不增加围手术期死亡率和严重并发症的发生率,可安全应用。Objective To evaluate the safety and effectively of transfusion plan guided by POTYS in gynecological patients with Hb level ranged from 60 to 100 g/L. Methods 114 gynecological patients with perioperative Hb level ranged from 60 to 100 g/L were randomly divided into POTTS group （ n = 57 ） and control group （ n = 57）. Patients in POTTS group received transfusion under the guidance of POTTS. Patients in control group received transfusion according to doctorg experience. The proportion of injecting RBCs,the amount of RBCs, the incidence of serious complications and mortality, ICU occupancy rate, postoperative Hb recovery, incision healing, hospitalization time, blood transfusion related costs and costs of hospitalization were observed and compared. Results The transfusion rate and volume in POTTS group were significantly lower than the control group （P 〈 0. 01 ）. Neither severe com- plications nor any mortality were found in each group. The transfusion costs in POTFS group were significantly less than the control group （P 〈 0. 01 ）. Two groups had no postoperative ICU admission;the postoperative Hh recovery, incision healing, hospitalization time and costs of hospitalization in two groups were not statistically significant. Conclusion POTTS could be safety and effectively used in gynecological patients with Hb level ranged from 60 to 100 g/L, also effectively save the blood, reduce the costs of blood transfusion, not increase perioperative mortality and the incidence of various complications.

关 键 词：围术期 输血指征 血红蛋白 安全性 有效性 

分 类 号：R614[医药卫生—麻醉学]