开放性输血和限制性输血对老年重症急性心力衰竭患者的临床效果及心功能的影响  

Clinical Effect of Open and Restrictive Blood Transfusion on the Elderly with Severe Acute Heart Failure and the Impact on Their Cardiac Function

作　　者：胡水英[1] 彭晓光[1] 徐高峰[1] Hu Shuiying;Peng Xiaoguang;Xu Gaofeng(The People＇s Hospital Macheng City,Hubei Province,438300,P.R.China)

机构地区：[1]湖北省麻城市人民医院,湖北麻城438300

出　　处：《老年医学与保健》2018年第4期417-419,共3页Geriatrics & Health Care

摘　　要：目的观察开放性和限制性输血对择期行髋关节置换术老年重症急性心力衰竭患者的临床效果和心功能的影响,为选择合适的临床输血方法提供依据。方法选取2016年5月—2017年5月我院收治的行择期手术的老年重急症心力衰竭患者100例,随机分为2组:观察组和对照组。术中对照组选取开放性输血,观察组应用限制性输血。对2组人均输血量、输血不良反应发生率、术后并发症发生率和死亡率以及术后心功能指标变化进行比较分析。结果观察组人均输血量、输血不良反应发生率以及术后并发症发生率和死亡率皆明显小于对照组(P<0.05);治疗前2组的LVESD、LVEF、E/A、LVEDD和6-MWT指标水平差异没有统计学意义(P>0.05),治疗后2组LVESD和LVEDD水平较治疗前明显下降,E/A、LVEF和6-MWT水平较治疗前显著上升;观察组LVESD和LVEDD水平下降水平以及E/A、LVEF和6-MWT上升水平均明显大于对照组(P<0.05)。结论在对老年重症急性心力衰竭患者行髋关节置换术过程中,限制性输血的效果优于开放性输血,具有一定的应用价值。Objective To compare the clinical effects of open and restrictive blood transfusion on the elderly with severe acute heart failure undergoing hip replacement and the impact on their cardiac function so as to provide bases for correct selection of transfusion method. Methods 100 elderly with severe acute heart failure, undergoing hip replacement during the period from May,2016 to May, 2017,were selected and randomly divided into 2 groups： observation group and control group; open blood transfusion was made to the elderly in control group in operation while restrictive blood transfusion was made to the elderly in observation group; the per capita amount of blood transfusion, the adverse reaction rate of blood transfusion, the occurrence of postoperative complications, the mortality and the changes of postoperative indexes of cardiac function of the elderly in the 2 groups were compared and analyzed. Results The per capita amount of blood transfusion, the adverse reaction rate of blood transfusion, the occurrence of postoperative complications and the mortality in observation group were lower than those in control group（P0.05）： there existed no statistical difference in the levels of LVESD, LVEF, E/A, LVEDD and 6-MWT between the2 groups before surgery（P0.05）; after surgery, the levels of LVESD and LVEDD in both groups were lower than those before surgery while the levels of E/A, LVEF and 6-MWT in both groups were higher than those before surgery, the decrease of the levels of LVESD and LVEDD and the increase of the levels of E/A, LVEF and 6-MWT in observation group were bigger than those in control group（P0.05）. Conclusions Restrictive blood transfusion in the elderly with severe acute heart failure undergoing hip replacement is of superior clinical effect to open blood transfusion and it is worthy of wider clinical application.

关 键 词：老年 重症急性心力衰竭 开放性输血 限制性输血 心功能 

分 类 号：R457.1[医药卫生—治疗学] R541.6[医药卫生—临床医学]