烧伤患者住院期间用血情况影响因素的回顾性分析  

Influencing factors of blood use in burn patients during hospitalization: A retrospective analysis

作　　者：王默然 王峻 葛艳玲[1] WANG Moran;WANG Jun;GE Yaning(Department of Blood Transfusion,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院输血科,北京100035

出　　处：《中国输血杂志》2021年第2期143-146,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨与烧伤患者住院期间输血相关的影响因素,为临床制定个体化的输血治疗方案提供参考依据。方法回顾性分析自2015年1月~2019年1月纳入本研究的火焰烧伤患者116例、高压电烧伤患者46例。统计两组患者的性别、年龄、身高、体重、体质指数BMI(body mass index, BMI)、烧伤面积、烧伤深度、烧伤部位、术中出血总量、术后引流量、手术次数、总住院天数、输血量、是否合并吸入性损伤、是否合并应激性溃疡、是否合并感染、是否合并高血压、糖尿病、是否合并心脏相关疾病、是否合并肝肾功能异常及是否合并低蛋白血症等因素。以P<0.05为差异有统计学意义。结果住院期间的平均输血量:火焰烧伤患者(29.26±26.18)U明显高于高压电烧伤(13.26±10.32)U。输血前平均血红蛋白浓度(g/L):火焰烧伤患者(91.49±15.11)g/L明显高于高压电烧伤(81.70±14.49)g/L;火焰烧伤与高压电烧伤患者在性别、BMI、烧伤面积、烧伤深度、烧伤部位等方面的差异具有统计学意义(P<0.05);当患者烧伤面积越大、累及躯干、手术次数≥6次、总住院天数≥100 d、术中总失血量≥2 000 mL、合并高血压、合并心脏相关疾病、合并肝肾功能异常及合并低蛋白血症等因素时将显著影响患者住院期间的平均输血量(P<0.05),其中术中失血总量对火焰烧伤患者的影响最为显著(r=0.60 P<0.05),烧伤部位对高压电烧伤患者的影响最强(r=0.44 P<0.05)。结论烧伤面积越大,烧伤深度越深,烧伤部位累及重要脏器和/或大血管,住院期间手术次数≥6次,术中失血量总和≥2 000 mL的严重烧伤患者住院期间的平均输血量大;当患者合并高血压、严重心和肝肾功能异常及低蛋白血症等因素时是患者住院期间输血量增加的高危因素,需得到临床医师高度重视。Objective To explore the influencing factors of blood transfusion in burn patients during hospitalization, so as to provide references for the development of individualized blood transfusion strategies. Methods 116 cases of flame burns and 46 cases of high-voltage burns from Jan 2015 to Jan 2019 were retrospectively analyzed. The gender, age, height, weight, body mass index(BMI), burn surface area, burn depth, burn site, intraoperative blood loss, postoperative flow, number of operations, hospital stays, blood transfusion amount, whether complicated with inhalation injury, stress ulcer, amalgamative infection, hypertension, diabetes, cardio-related diseases, abnormal liver and kidney function and hypoalbuminemia in those two groups were statistically analyzed. Results During hospitalization, the mean blood volume of flame burn cases was(29.26±26.18)U, significantly higher than high-voltage burn cases as(13.26±10.32)U. The mean hemoglobin concentration(g/L) before blood transfusion of flame burn cases was(91.49±15.11)g/L, significantly higher than high-voltage burn cases as(81.70±14.49)g/L. There were statistically significant differences in gender, BMI, burn surface area, burn depth and burn site between flame burn cases and high-voltage burn cases(P<0.05). The average volume of blood transfusion during hospitalization was significantly affected by such factors as large burn area, trunk involvement, total intraoperative blood loss ≥2 000 mL, number of operations ≥6 times, hospital stay≥100 days,hypertension, cardio-related diseases, abnormal liver and kidney function, hypoproteinemia and so on(P<0.05), among which the total amount of intraoperative blood loss had the most significant effect on the flame burn patients(P<0.05), and the burn site had the most significant effect on the high voltage burn patients(P<0.05). Conclusion Large burn area, deep burn depth, important organs and/or large blood vessels involvement, number of operations ≥6, and the total intraoperative blood loss ≥2 000 mL contribu

关 键 词：火焰烧伤 高压电烧伤 输血治疗 影响因素 

分 类 号：R644[医药卫生—外科学] R457.1[医药卫生—治疗学]