术中血液回收用于血管外科手术的单中心回顾性分析  

Single-center retrospective analysis of intraoperative cell salvage in vascular surgery

作　　者：陶星[1] 董鹏[1] 肖英港[1] 朱欣艳 Tao Xing;Dong Peng;Xiao Yinggang;Zhu Xinyan(Department of Anesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《中国体外循环杂志》2021年第3期159-162,共4页Chinese Journal of Extracorporeal Circulation

基　　金：北京市自然科学基金(7122050)。

摘　　要：目的回顾北京友谊医院20年术中血液回收(IOCS)在血管外科手术中的使用情况,分析不良事件。方法调取2000年5月至2019年12月的IOCS记录表和输血不良反应上报记录,收集血管外科手术行IOCS病例的诊断、手术名称、回输血量和不良事件。平均回输血量采用中位数表示。结果20年共实施IOCS 1004例,其中742例(73.8%)进行了回输。未回输的首要原因是回收血量少(n=252,96.2%),其次是回收血液被污染(n=10,3.8%)。报告的46例不良事件,均为Ⅳ级,其中26例是记录不完全、5例仪器故障、3例安装操作错误、12例影响红细胞回输。无患者相关不良事件发生。结论IOCS用于血管外科手术的安全性高。根据患者病情、术中情况和供血条件制定合理的血液管理方案,遵守标准操作规程,最大限度确保IOCS技术的安全性和有效性。Objective To summarize the application and analyze adverse events of intraoperative cell salvage(IOCS)in vascular surgery by reviewing the data of 20 years in a general university hospital of Beijing.Methods The IOCS recording book and adverse transfusion reaction log of vascular surgery were reviewed from May 2000 to Dec 2019.The diagnoses,operative names,volumes of salvaged blood,adverse events and remarks from the recording were extracted and analyzed.Results There were 1004 patients for whom the IOCS and vascular surgery were done during the past 20 years.Salvaged blood returned to 742(73.8%)patients successfully,while 262 patients failed to receive IOCS(252 for little blood was salvaged,and 10 for blood contamination).Of all the 46 adverse events classified as gradeⅣ,26 cases were uncompleted recording,5 cases were mechanical disorder,3 case were operation mistakes,12 cases were contaminated.There was no patient-related adverse event.Conclusion The use of IOCS in vascular surgery is safe according to the incidence of adverse events of IOCS during the past 20 years.In order to promise the safety and effectiveness of IOCS,strictly training,carefully evaluating the patients and the operations,obtaining the standard operative procedure,effectively communicating among the staffs,recognizing the contraindications,and properly planning the patient blood management according to the operation and blood bank inventory are necessary.

关 键 词：自体血液回收 血液回输 不良事件 血管外科手术 

分 类 号：R654.3[医药卫生—外科学]