本院储存式自体输血的临床应用及问题分析  

Clinical application and problem analysis of stored autologous transfusion in our hospital

作　　者：李小薇[1] 范秀 刘娟[1] 李翠莹[1] 

机构地区：[1]空军总医院输血科,北京100142

出　　处：《中国输血杂志》2017年第9期1027-1030,共4页Chinese Journal of Blood Transfusion

摘　　要：目的自体输血的应用可减少异体输血和输血传播疾病,且能有效避免同种免疫反应,应受到重视。方法2013-2015年本院储存式自体输血情况进行统计,并初步分析2015年4个外科科室储存式自体血的应用,同时统计自体血报废率。选取2015年1-12月择期手术患者216例符合储存式自体输血指征作为研究对象,随机分成2组,术前储备自体血,手术过程中或术后仅输注自体血患者135例为观察组;术前未进行自体血储存,手术过程中或术后输注异体血患者81例为对照组。对比2组患者的输血不良反应发生率、平均住院日等资料,并做统计学分析。结果 2013-2015年储存式自体输血共采集756例,采集自体血1 385 U,主要分布在普通外科(340/756,45.0%)、血液科(176/756,23.3%)、泌尿外科(122/756,16.1%)及妇产科(46/756,6.1%),占90.5%(684/756)。3年储存式自体血报废率约为6.6%(91.5 U/1385 U)。与对照组相比,观察组患者平均住院日显著降低(20.38±8.868 vs 23.23±11.718,P<0.05)。其中泌尿外科患者平均住院日显著降低(17.28±5.575 vs 24.16±14.546,P<0.05)。结论对于手术出血量较少(≤800 mL)的择期手术患者而言,储存式自体输血是一种安全有效的备血方案,可缓解血液紧张对手术的影响,利于患者术后恢复,缩短患者平均住院时间。因此,应加大储存式自体输血的宣传与推广,另需重视其报废情况。Objective The application of autologous blood donation can decrease allogeneic blood transfusion and transmitted disease,and can effectively avoid the homoimmune reaction,should be taken seriously.Methods Statistical analysis of the clinical use of autologous blood in our hospital during 2013-2015,and summarized the unused rate about storage of autologous blood transfusion.Meanwhile,the application of stored autologous blood in 4 surgical departments in 2015 was analyzed.The patients（n = 216） received surgical operation from January to December 2015,were collected and divided into two groups.The control group（n = 81） consisted of patients who did not donate autologous blood,and transfused allogeneic blood during surgery or surgery.135 cases who donated autologous blood,and transfused autologous blood during operation or after operation were observation group.The incidence of adverse effects of blood transfusion and average hospital stay were compared between the two groups,and statistical analysis was performed.Results Stored autologous blood collected 756 cases（1 385 U）,mainly distributed in the general surgery（340/756,45.0%）,hematology（176/756,23.3%）,urinary surgery（122/756,16.1%）,and gynecology obstetric（46/756,6.1%）,accounting for 90.5%（684/756）.The storage of autologous blood transfusion in 2013-2015 unused rate is about 6.6%（91.5 U/1 385 U）.Compared with the allogeneic blood transfusion group,the average hospital stay and of autologous transfusion were significantly lower（20.38±8.868 vs 23.23±11.718,P〈0.05）.Average hospital stay in urinary surgery was remarkably decreased（17.28±5.575 vs 24.16±14.546,P〈0.05）.Conclusion Autologous blood transfusion is a safe and effective blood transfusion regimen for elective surgery patients with less operative bleeding（≤800 m L）.It can relieve the influence of blood tension,reduce the amount of intraoperative blood loss,facilitate postoperative recovery,and lessen the patient＇s medical expenses.Therefore,storage o

关 键 词：储存式自体输血 异体输血 择期手术 

分 类 号：R457.1[医药卫生—治疗学]