学龄儿童脊柱侧凸矫形术中自体血回输对节约用血和费用的影响  

Efficacy and costs of intraoperative autologous blood transfusion in instrumented posterior correction and fusion surgery for scoliosis in school-aged children

作　　者：苗玉良[1] 刘艳[1] 王晓平[2] 马华松[2] 方伟武[1] 时文珠[3] MIAO Yuliang;LIU Yan;WANG Xiaoping(Department of Anesthesiology,306 Hospital of Chinese People's Liberation Army,Beijing 100101,China)

机构地区：[1]中国人民解放军第306医院麻醉科,北京100101 [2]中国人民解放军第306医院骨科,北京100101 [3]北京市解放军总医院麻醉手术中心

出　　处：《浙江医学》2019年第8期810-812,816,共4页Zhejiang Medical Journal

摘　　要：目的探讨学龄儿童脊柱侧凸矫形手术中,自体血回输技术是否可节约用血和医疗费用。方法收集107例行脊柱侧凸矫形手术的7～12岁学龄儿童资料。根据是否采用cell saver 5自体血回输机,分为对照组和自体血回输组(cell saver组)。采用卡钳法进行倾向值匹配后,52例患者的资料匹配成功,观察其围术期各项指标并进行输血相关费用评价。结果与对照组相比,cell saver组的异体红细胞及血浆输注量在术中、术后和整个围术期差异均无统计学意义(均P>0.05);ICU入住时间和术后住院日等其余指标及医疗费用差异也均无统计学意义(均P>0.05)。结论在学龄儿童脊柱侧凸术中,自体血回输不能减少异体红细胞和血浆的需求,也并不经济合算。Objective To evaluate the efficacy and costs of intraoperative autologous blood transfusion in instrumented posterior correction and fusion surgery for scoliosis in school-aged children.Methods In this single-center,retrospective study 107 school-aged children with scoliosis,who underwent posterior spinal instrumentation and fusion surgery between January 2015 and December 2017,were enrolled.The autologous transfusion was performed intraoperatively with a cell saver in 30 patients(cell saver group)and not performed in 77 patients(control group).The perioperative indexes and the cost of blood transfusion were compared between two groups.Results The propensity score matching produced 26 matched pairs.There were no significant differences in intraoperative,postoperative and perioperative allogeneic RBC(P=0.205,0.790 and 0.400)and fresh frozen plasma transfusions(P=0.140,0.844 and 0.328)between cell saver group and control group.There was also no significant difference in the costs between two groups(P=0.235).Conclusion The use of the cell saver will not decrease the amount of allogeneic RBC and fresh frozen plasma transfusion and not reduce the costs of instrumented posterior correction and fusion surgery for scoliosis in school-aged children.

关 键 词：自体血回输技术 脊柱侧凸 输血 儿童 费用收益分析 

分 类 号：R726.8[医药卫生—儿科]