预存式自体输血在腰椎后路手术中的应用  

Preoperative blood donation in posterior lumbar surgery: a retrospective review

作　　者：于帅[1] 黄用文 付振书[3] 林梦霞[2] 吴月清[2] 冯倩[3] 闻巍[3] 于洋[3] 

机构地区：[1]解放军总医院海南分院检验中心,海南三亚572013 [2]解放军总医院海南分院输血科,海南三亚572013 [3]解放军总医院,100853

出　　处：《中国输血杂志》2016年第1期71-73,共3页Chinese Journal of Blood Transfusion

基　　金：海南省应用技术研发与示范推广专项(ZDXM201412)

摘　　要：目的探讨术前预存式自体输血在腰椎后路手术的临床疗效及应用价值。方法选择2012年3月-2015年3月行腰椎后路手术患78名,自体血组和对照组各39例。患者年龄16-70岁,患者心肺功能及身体状况良好,采血前Hb:男≥120 g/L,女≥110 g/L。按照术前是否进行PBD,分为自体血组和对照组。记录并比较2组患者的总住院时间、术后住院时间、输血相关费用、术中出血量、术后引流量、术后Hb以及异体输血量。结果 2组的术中出血量、术后引流量和术后Hb均不具统计学意义(P>0.05);自体血组的平均术后住院时间、平均总住院时间、平均输血相关费用和异体红细胞输注率(8.95±2.87)d、(12.28±4.05)d、(174.70±323.76)元、7.69%,均低于对照组水平(13.38±8.68)d、(18.49±8.86)d、(779.36±823.15)元、47.22%,2组比较差异具统计学意义(P<0.05)。结论对腰椎后路手术患者采用PBD可有效纠正术中、术后失血性贫血,同时PBD患者术后恢复快,住院时间少,减轻患者经济负担,同时可显著减轻对异体血的依赖。Objective To investigate the clinical effect and application value of blood donation preoperative（ PBD） in posterior lumbar surgery. Methods From March 2012 to March 2015,78 patients underwent posterior lumbar operation.They ranged between 16 to 70 years with optimal heart and lung function and physical conditions. Their level of hemoglobin（ HB） was higher in males（ more than or equal to 120 g/L） and while in females,the HB levels were more than or equal to110 g / L. Patients were divided into autologous transfusion group and control group which did not receive blood transfusion.The total hospital stay,postoperative hospital stay,blood transfusion related costs,bleeding volume,postoperative drainage,postoperative Hb and allogeneic blood transfusion were compared. Results A total of 78 patients were included in the study,with 39 patients in each group. There was no significant difference between the two groups in the amount of bleeding in operation,postoperative drainage and postoperative hemoglobin（ P〉0. 05）. There were significant differences between the two groups in total hospital stay,postoperative hospital stay,blood transfusion related costs,the rate of allogeneic red blood cell transfused（ 8. 95 ＋ 2. 87 days vs. 13. 38 ＋ 868 days,12. 28 ＋ 405 days vs. 18. 49 ＋ 886 days,and 174. 70 ± 323. 76 yuan vs. 779. 36 ± 823. 15 yuan,7. 69% vs 47. 22%）（ P〈0. 05）. Conclusion For posterior lumbar surgery patients,PBD can effectively correct anemia from intra-or post-operative hemorrhage,achieve quicker recovery after operation,reduce hospital stay,decrease patients＇ economic burden and significantly reduce the dependence on allogeneic blood.

关 键 词：预存式自体输血 腰椎后路手术 住院时间 

分 类 号：R457.1[医药卫生—治疗学] R687.3[医药卫生—临床医学]