围手术期输血对骨科患者术后转归的影响  

Effect of perioperative blood transfusion on outcome of patients in orthopedic surgery

作　　者：唐晨[1] 齐祺[1] 杨懿岚 夏荣[1] 张琦[1] 

机构地区：[1]复旦大学附属华山医院输血科,上海200400

出　　处：《中国输血杂志》2017年第7期714-716,共3页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金面上项目(81570166);上海市公共卫生重点学科建设项目(15GWZK0501)

摘　　要：目的分析骨科围手术期用血情况以及输血对术后病情转归的影响,以期为骨科围手术期科学合理输血提供依据。方法回顾分析2015年10月-2016年9月在骨科接受手术治疗患者围手术期用血情况相关病史资料。结果共收集骨科手术患者临床资料201例,其中未输血患者为90例,输血患者为111例(大量输血组输注红细胞数量>800 m L,17例;非大量输血组输注红细胞数量≤800 m L,94例)。输血组出院前血红蛋白水平为(103.09±16.37)g/L低于非手术组(115.79±13.68)g/L,术后住院时间输血组(12.012±8.36 d)高于非输血组(16.14±10.47d),分析术后感染情况显示在未输血组感染率为1.11%,而输血组感染率为15.32%,其中在17例大量输血患者中就有9例发生了术后感染(52.94%)。结论围手术期输血不利于骨科患者术后血红蛋白水平恢复,增加术后感染发生率延长住院时间,因此骨科围手术期应严格参照输血指征并加强患者血液管理以降低围手术期用血概率,以利于术后疾病恢复。Objective To analyze the effect of perioperative blood transfusion in orthopedic surgery.Methods A total of 201 patients who underwent an orthopedic surgery in our hospital in October 2015 to September 2016 were reviewed. Hemoglobin concentrations, hematoerit, postoperative hospital stay, infection and other related data were analyzed. Results 90 patients were transfused with blood and in 111 patients were not during orthopedic surgery （massive blood transfusion group including 17 cases; non massive blood transfusion group including 94 cases）. Hemoglobin concentrations of transfusion group （ 103.09± 16. 37） g/L was lower than the non transfusion group （ 115.79±13.68） g/L before living hospital, postoperative hospitalization time of transfusion group （ 12. 012± 8.36） was longer than that of non transfusion group （16. 14 ± 10. 47 ） days. Postoperative infection rate in non transfusion group was 1.11%, and in transfusion group was 15.32%, in massive transfusion group is 52. 94%. Conclusion Perioperative blood transfusion is not conducive to the recovery of hemoglobin level patients in orthopedic surgery, prolong hospital stay and increase the rate of infection after surgery. Perioperative blood transfusion makes it difficult to support the outcome of the disease

关 键 词：骨科 围手术期输血 术后转归 

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