170例择期手术患者贮存式自体输血的应用情况分析  

Analysis of the application of preoperative autologous blood donation in 170 patients undergoing elective surgery

作　　者：傅明玮[1] 吴瑛 李聚林[1] FU mingwei;WU ying;LI Julin.(Department of blood transfusion, The 181st Hospital of PLA, Guilin 541002, China)

机构地区：[1]解放军第181医院输血科

出　　处：《中国输血杂志》2018年第2期172-175,共4页Chinese Journal of Blood Transfusion

基　　金：广西医药卫生科研项目(Z20170978)

摘　　要：目的了解本院近年来贮存式自体输血（PABD）的应用情况,为下一步PABD发展提供依据。方法选择2014—2016年本院5个临床科室所有开展PABD的择期手术患者170例,计算择期手术患者PABD的使用比例,比较年龄、体重、采血量、手术失血量、贮血至手术时间的差异,观察采血前后和手术前后RBC、Hb、Hct、Plt数量变化,以及献血和输血不良反应发生情况并统计分析。结果本院择期手术患者PABD的应用比例较低,患者手术前后的RBC数与采血前后Plt数差异无统计学意义（P〉0.05）。泌尿外科经皮肾镜碎石术、穿刺取石术和造瘘取石等术3类患者采血量、采血前Hb、手术后Hb、手术失血量、贮血至手术间隔天数差异均无统计学意义（P〉0.05）,术后血红蛋白≥100 g/L者占88.52%（117/136）。3例患者在采集自体血时出现轻度献血反应。44例患者将贮存的自体血在术中或术后全部回输,未发生任何输血不良反应。1名患者自体贮血量不够,使用了同种异体血。结论PABD相对安全与节约血液资源,本院在促进PABD方面还有很大发展潜力与空间,有关部门可针对具体情况,加大应用与管理力度,使我院PABD更好地健康发展。Objective To acquire an overview understanding of the application of preoperative autologous blood donation（ PABD） in recent years,and to provide the basis for the future development of PABD. Methods A total of 170 patients undergoing elective surgery in all clinical departments of our hospital from 2014 to 2016 were enrolled with the proportion of PABD calculated. The differences in age,body weight,blood loss,operation blood loss,and blood storage duration were compared. The changes of RBC,Hb,Hct and Plt were observed before and after the blood collection and before and after the operations. The incidence of blood donation and blood transfusion was observed and analyzed statistically. Results The proportion of PABD in patients with elective surgery was low,and differences in the number of RBC before and after the operation and the number of Plt before and after the blood transplantation were not statistically significant. There were no significant differences in Hb,postoperative Hb,operation blood loss,and hemodialysis to the operation interval（ P〉0. 05）.There was no significant difference between the two groups（ P〉0. 05）. Postoperative hemoglobin ≥ 100 g/L accounted for88. 52%（ 117/136） of the patients. 3 patients had mild blood donation when collecting autologous blood. 44 patients received autologous blood transfusion during or post operation and did not present any blood transfusion adverse reactions. 1 patient suffered from insufficient autologous blood storage and had to use allogeneic blood. Conclusion PABD is relatively safe and can save blood resources. There is still room for our hospital to further promote the application of PABD. The relevant government departments can judge to the situation and promote PABD application with strengthened regulations. This would further assure improved application of PABD in our hospital.

关 键 词：贮存式自体输血 择期手术 应用 

分 类 号：R457.1[医药卫生—治疗学] R61[医药卫生—临床医学]