两种红细胞在体外循环心脏手术中应用效果比较  

Comparison of non-transfusion and different kinds of red blood cells transfusion in patients undergoing cardiac surgeries with cardiopulmonary bypass

作　　者：高旭蓉[1] 马丽[1] 张颖[1] 刘娜[1] 马祖轩[1] 纪宏文[1] 

机构地区：[1]国家心血管病中心中国医学科学院阜外心血管病医院输血科,北京100037

出　　处：《北京医学》2016年第2期164-167,共4页Beijing Medical Journal

摘　　要：目的比较去白细胞悬浮红细胞和悬浮红细胞在体外循环心脏手术患者输注后的效果分析。方法连续入选889例拟行体外循环心脏手术的患者,将需要输血的患者(643例)随机分为去白细胞悬浮红细胞组(简称去白组,322例)和悬浮红细胞组(简称悬红组,321例),未输血的患者归为未输血组(246例),去白组患者只接受去白细胞悬浮红细胞的输注,悬红组患者只接受悬浮红细胞的输注。对比3组患者红细胞和血浆输注量,WBC、Hb,术后机械通气时间,重症加强护理病房(ICU)停留时间,术后住院时间和住院费用。结果术前一般资料去白组与悬红组差异均无统计学意义(P>0.05)。与去白组和悬红组比较,未输血组患者年龄小、体重大、术前血红蛋白水平高,差异有统计学意义(P<0.01)。红细胞输注量去白组与悬红组比较差异有统计学意义(P<0.01);术后机械通气时间未输血组[(26.7±9.5)h]、去白组[(38.9±39.5)h]、悬红组[(48.7±66.1)h]3组间比较差异有统计学意义(P<0.01);ICU停留时间未输血组[(1.7±1.1)d]、去白组[(2.6±2.0)d]、悬红组[(3.0±3.9)d]3组间比较差异有统计学意义(P<0.05);未输血组术后住院时间短(P<0.05),住院费用低,差异有统计学意义(P<0.01)。结论与输注悬浮红细胞相比,体外循环心脏手术患者输注去白细胞悬浮红细胞有利于术后早期恢复,缩短术后机械通气时间和ICU停留时间。Objective To compare the effects of different kinds of red blood cell transfusion in patients undergoing heart surgery with cardiopulmonary bypass and to analyze the characteristics of patients without blood transfusion. Methods Eight hundred and eighty-nine consecutive patients with transfusion undergoing cardiac surgery with cardiopulmonary bypass were randomly assigned into two groups： the leukocyte- reduced suspended red blood cell transfusion group（322 cases） and the suspended red blood cells transfusion group（321 cases）. The non-transfusion patients were used as the group（246 cases）. Patients who required transfusion therapy perioperatively, either received leukocyte-reduced suspended red blood cell or ordinary suspended red blood cell. Outcome measures included red blood cell and plasma volume, white blood cell count, hemoglobin levels, duration of postoperative mechanical ventilation, ICU stay time, length of postoperative stay and hospitalization expenses. Results There was no significant difference in the demographic data between the leukocyte-reduced suspended red blood cell group and the suspended red blood cells group（P〈0.05）. Compared with the transfusion group, patients of the non-transfusion group was younger, the weight was higher, the preoperative hemoglobin levels was higher. There was statistically significant difference between non-transfusion group and transfusion group（P〈0.01）. There was statistically significant differences in the volume of red blood cell between the leukocyte- reduced suspended red blood cell group and the suspended red blood cells group（P〈0.01）. There was no significant difference in plasma volume, postoperative hemoglobin levels and white blood cell count between the three groups（P〈0.05）. There was statistically significant difference in the duration of postoperative mechanical ventilation between the three groups（non- transfusion group（26.7 ± 9.5）h, the leukocyte- reduced suspended red blood cell group（38.9 ± 39.5）h, th

关 键 词：心脏手术 体外循环 输血 去白细胞悬浮红细胞 

分 类 号：R654.1[医药卫生—外科学]