淋巴水肿脂肪抽吸减容术中自体输血阈值研究  

Threshold study of autologous transfusion in liposuction surgery of lymphedema patients

作　　者：陈麟凤 常鲲[2] 陈岩 何欣 吴薇 沈文彬[2] Chen Linfeng;Chang Kun;Chen Yan;He Xin;Wu Wei;Shen Wenbin(Department of Blood Transfusion,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Lymph Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Medical Department of Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院输血科,100038 [2]首都医科大学附属北京世纪坛医院淋巴外科,100038 [3]首都医科大学附属北京世纪坛医院医务处,100038

出　　处：《中华整形外科杂志》2021年第10期1109-1113,共5页Chinese Journal of Plastic Surgery

基　　金：首都医科大学附属北京世纪坛医院院内科研专项课题(2019-LB09)。

摘　　要：目的探索一种方便有效的计算淋巴水肿脂肪抽吸减容术中失血量的方法,以建立术中自体血输注阈值。方法收集首都医科大学附属北京世纪坛医院2016年1月至2019年12月因淋巴水肿而进行脂肪抽吸减容手术患者的临床信息、实验室检测和手术相关信息,分析术中吸脂量、血性液体量、手术时间、患者体质量等因素对术中失血量的影响,构建术中失血量拟合公式,比较医生记录和公式计算的失血量之间的差异,并建立患者术中自体血回输阈值。结果共收集1136例脂肪抽吸减容手术患者资料,男65例,女1071例,未输血组年龄中位数56岁,输血组55岁。手术前后体质量变化、术中吸脂总量、血性液体量、手术时间均与术中失血量呈正相关(Spearman系数分别为0.590、0.584、0.560、0.520,P<0.01)。Hemoglobin balance公式计算的理论失血量为(753.0±418.2)ml,根据失血量计算值得到术中失血量拟合公式y(ml)=0.082×吸脂总量+365,根据公式计算出需进行自体血回输的吸脂量阈值为2900 ml。结论该研究构建了一种便于应用的脂肪抽吸减容手术术中的失血量计算方式,建立了脂肪抽吸手术进行自体血回输的阈值,从而确立了患者需要尽早输血的指征。Objective To explore a convenient and effective method for calculating intraoperative blood loss in liposuction and volume reduction surgery for establishing intraoperative autologous blood transfusion threshold.Methods Patients’clinical,laboratory and surgery related information were collected.The influence of different factors such as the total amount of liposuction,bloody fluid,operation time,and patients’weight change on blood loss during operation were analyzed.The difference of volume between blood loss recorded by doctors and theoretical calculations was compared.The formula of blood loss during operation was conducted,and then the threshold of autologous blood transfusion was established.Results A total of 1136 patients with liposuction due to lymphedema were recruited.There were 65 males and 1071 females,the median age was 56 years in the non-transfusion group and 55 years in the transfusion group.The total amount of liposuction,bloody fluid,operation time,and body weight changes in patients with liposuction surgery were statistically positively correlated with intraoperative blood loss(spearman coefficient were 0.590,0.584,0.560,0.520,respectively,P<0.01).The theoretical blood loss calculated by the Hemoglobin balance formula is(753.0±418.2)ml.According to the calculated value of blood loss,the intraoperative blood loss fitting formula y(ml)=0.082×total liposuction+365,is abtained.The threshold for reinfusion of autologous blood is 2900 ml of liposuction amount.Conclusions In this study,a convenient calculation method of blood loss in liposuction and volume reduction surgery was constructed,and a threshold for autologous blood transfusion in surgery was set up.Thus,the indication of early blood transfusion was established.

关 键 词：输血 自体 脂肪抽吸 失血量 输血阈值 

分 类 号：R622.9[医药卫生—整形外科]