心血管外科手术血小板输注特点分析  

Analysis of the characteristics of platelet transfusion in cardiovascular surgery

作　　者：潘楠[1] 高旭蓉[1] 贾金娜[1] 齐虹美[1] 马丽[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北京协和医学院阜外医院输血科,北京100037

出　　处：《北京医学》2016年第11期1221-1224,共4页Beijing Medical Journal

摘　　要：目的分析1 335例心血管外科需要输注血小板患者的手术种类、输注率（量）和输注时机,为心血管手术血小板的预订和输注提供参考数据。方法实时登记2013年1-12月阜外医院实施心血管外科手术并输注血小板的所有患者资料,统计分析手术种类和输注时机。结果 2013年共完成心血管外科手术11 439例,1335例患者围术期输注血小板,共2 037治疗量。血小板总输注率为11.7%,接受血小板输注患者的人均用量为（1.53±1.20）治疗量。全主动脉弓替换联合象鼻支架术和胸降主动脉替换术的血小板输注率较高,分别为91.5%和100%;其中胸降主动脉替换术的人均用量最大,为（3.07±1.59）治疗量。血小板输注时机：术前无血小板输注,术中输注血小板846例,占63.37%;术后输注血小板382例,占28.61%;术中和术后均输注血小板者107例,占8.01%。结论心血管外科手术中血小板输注率较高,血小板的需求主要取决于手术种类、体外循环时间、术前血小板功能和数量等因素。Objective To analyze the type of surgery, infusion rates and timing of platelet transfusion in 1 335 patients underwent cardiovascular surgery, to provide reference data of platelet transfusion and reservation for cardiovascular surgery. Methods The data of all patients who underwent cardiac surgery with platelet transfusion from January to December in 2013 at Fuwai Hospital were real-timely registered. Statistical analysis was conducted based on the type of surgery and transfusion time. Results A total of 11 439 cases of cardiovascular surgery were completed in 2013, 1 335 patients received platelet transfusion perioperatively and 2 037 platelet were transfused, the overall rate of platelet transfusion was 11.7%, while the amount of platelet transfusions patients received per capita was（1.53±1.20） platelet doses. The platelet transfusion rate was higher in patients undergoing total aortic arch replacement combined with stented elephant trunk surgery, and descending thoracic aortic replacement, which was 91.5% and 100% respectively; the maximum amount of platelet transfusion per capita happened in patients with descending thoracic aortic replacement, which was（3.07±1.59） platelet doses. Taking the timing of platelet transfusions into account, preoperative platelet transfusion rate was zero, 846 cases（63.37%） were transfused intra-operatively only, 382 cases（28.61%） were transfused postoperatively, and 107 cases（8.01%） were both transfused intra- and postoperatively. Conclusion The intraoperative platelet transfusion rate is high in cardiovascular surgery. Platelet demand depends on the type of surgery, cardiopulmonary bypass（CPB） time and preoperative platelet function and quantity.

关 键 词：血小板 输血 心血管外科手术 体外循环 

分 类 号：R654[医药卫生—外科学] R457.1[医药卫生—临床医学]