膀胱癌根治术患者围手术期血液管理探讨  

Discussion on Perioperative Blood Management of Patients Undergoing Radical Bladder Cancer Surgery

作　　者：许爱珍 赵伟平[2] XU Ai-zhen;ZHAO Wei-ping(Yiwu Traditional Chinese Medicine Hospital;Sir Run Run Shaw Hospital,Zhejiang University School of Medicine)

机构地区：[1]浙江省义乌市中医医院 [2]浙江大学医学院附属邵逸夫医院

出　　处：《医院管理论坛》2020年第8期33-35,共3页Hospital Management Forum

摘　　要：目的探讨膀胱癌根治术患者围手术期血液管理方法及效果。方法选择义乌市中医医院2014年1月至2018年12月膀胱癌根治术患者140例,根据随机数字法分为对照组和血液管理组,每组70例。对照组患者围手术期进行常规管理,血液管理组患者围手术期进行血液管理。记录两组患者手术时间、术中出血量、输血例数、总输血量、住院时间和住院费用,术前及术后(术后3天)红细胞压积和血红蛋白浓度。结果与对照组比较,血液管理组患者术中出血量和输血量减少(p<0.05),输血例数减少(p<0.05),住院时间缩短(p<0.05),住院费用减少(p<0.05)。术前,两组红细胞压积和血红蛋白浓度比较差异无统计学意义(p>0.05);术后,两组红细胞压积和血红蛋白浓度均低于术前(p<0.05),但血液管理组红细胞压积和血红蛋白浓度高于对照组(p<0.05)。结论膀胱癌根治术患者进行血液管理可有效减少术中出血量和输血量,升高术后红细胞压积和血红蛋白浓度,缩短住院时间,减少住院费用。Objective To explore the perioperative blood management methods and effects of patients undergoing radical bladder carcinoma surgery.Methods A total of 140 patients with bladder carcinoma radical surgery from January 2014 to December 2018 in Yiwu Traditional Chinese Medicine Hospital were selected and divided into a control group and a blood management group according to random number method,with 70 cases in each group.Patients in the control group were routinely managed during the perioperative period,and patients in the blood management group were performed blood management during the perioperative period.The operation time,intraoperative bleeding,cases of blood transfusions,total blood transfusion volume,days of hospitalization,hospitalization costs,hematocrit and hemoglobin concentration before and after surgery(3 days after surgery)were recorded in both groups.Results Compared with the control group,the intraoperative bleeding,blood transfusion volume,the cases of blood transfusions,days of hospitalization and the hospitalization cost was reduced(p<0.05)in the blood management group.Before operation,there was no statistically significant difference in hematocrit and hemoglobin concentration between the two groups(p>0.05).After operation,both hematocrit and hemoglobin concentration in the two groups were lower than before operation(p<0.05),but the hematocrit and hemoglobin concentration in the blood management group were higher than those in the control group(p<0.05).Conclusion Blood management for patients undergoing radical bladder carcinoma surgery can effectively reduce intraoperative bleeding and blood transfusion volume,increase postoperative hematocrit and hemoglobin concentration,shorten days of hospitalization,and reduce hospitalization costs.

关 键 词：膀胱癌 根治术 血液 输血 

分 类 号：R197.5[医药卫生—卫生事业管理]