全子宫切除术异体红细胞输注情况分析  

Analysis of allogeneic blood transfusion following panhysterectomy

作　　者：蔡娟[1] 朱正荣[1] 宋金凤[1] 

机构地区：[1]安徽医科大学附属六安医院输血科,安徽六安237005

出　　处：《中国输血杂志》2017年第6期621-623,共3页Chinese Journal of Blood Transfusion

摘　　要：目的回顾分析本院妇科全子宫切除术的临床病例资料,总结全子宫切除术输血治疗现状和特点。方法收集2014-2017年在本院行妇科全子宫切除术的病例,统计其中围术期输血病例,分析不同术中出血量、不同手术方式等输血情况及特点,比较组别间输注红细胞的量及输血前后指标变化。结果本院全子宫切除术患者输血率20.1%,术前输血量占66.3%,平均红细胞输注量(3.8±1.9)U,平均红细胞输注量术前>术中>术后且差异具有统计学意义。输血病例不同术中出血量平均RBC输注量差异无统计学意义。不同Hb指征的比较:输血率、术前输血率及术前输血量,Hb<80 g/L组最高,差异有统计学意义。不同手术方式比较:术中出血量以开腹全切最多,腹腔镜全切次之,阴式切除最少;术中后输血率有差异,术中术后平均RBC输注量无差异。不同输血量的比较:各组之间输血前后Hb差值比较,差异具有统计学意义。结论我院全子宫切除术输血指征把握较好,输血疗效较好;应选择恰当手术方式,积极开展微创手术,减少异体血输注。Objective To summarize the present status and characteristics of blood transfusion treatment for patients undergoing panhysterectomy in our hospital.Methods Clinical data of patients underwent panhysterectomy were collected,from 2014 to 2017.The proportion of perioperative blood transfusion cases was calculated,and impacts of intraoperative blood loss and surgical procedures on blood transfusion amount and RBC/Hb were also analysed.Results The allogeneic transfusion ratio of patients undergoing panhysterectomy was 20.1%,while preoperative transfusion ratio was 66.3%.The mean volumn of infused blood was（3.8±1.9） U,and there were significant differences among the preoperative,intraoperative and postoperative groups（P〈0.05）,while the differences were not statistically significant among different intraoperative blood loss groups.Comparisons of different Hb content groups：the group of Hb80 g/L had highest ratio and largest volumn of transfusion,the differences showed statistical significance.Comparisons of different surgical procedure groups：amount of intraoperative blood loss was the largest in panhysterectomy group through laparotomy,the second in laparoscopy group,the least in transvaginal panhysterectomy group.There were significant differences among the three surgical procedure groups according to transfusion ratio.Comparisons of different transfusion volumn：There were significant differences of Hb concentration before and after transfusion among the four groups.Conclusion The disposal plan of the doctors in our hospital is suitable for transfusion in panhysterectomy patients.We should choose better strategies including selection of appropriate surgery procedures,application of minimally invasive surgery to reduce allogeneic blood transfusion.

关 键 词：全子宫切除术 围术期 输血 

分 类 号：R457.1[医药卫生—治疗学] R713.42[医药卫生—临床医学]