输血指征评分指导手术患者输注红细胞的安全性和有效性研究  

Safety and effectiveness of Perioperative Transfusion Trigger Score on perioperative allogeneic RBC transfusions in surgical patients

作　　者：梁树聪 黄泽汉[2] 黄燕娟 潘凤婷 王亚峰[3] 黄爱兰[3] 廖刃[4] LIANG Shucong;HUANG Zehan;HUANG Yanjuan;PAN Fengting;WANG Yafeng;HUANG Ai-lan;LIAO Ren(Department of Anesthesiology,The Third Affiliated Hospital of Guangxi Medical University,Nanning 530031,China;Department of Anesthesiology,Affiliated Hospital of Youjiang Medical University far Nationalities;Department of Anesthesiology,People's Hospital of Guangxi Zhuang Autonomous Regio;Department of Anesthesiology,West China Hospital,Sichuan University)

机构地区：[1]广西医科大学第三附属医院麻醉科,广西南宁530031 [2]右江民族医学院附属医院麻醉科 [3]广西壮族自治区人民医院麻醉科 [4]四川大学华西医院麻醉科

出　　处：《中国输血杂志》2022年第1期29-32,共4页Chinese Journal of Blood Transfusion

基　　金：广西重点研发计划(桂科AB17292043)。

摘　　要：目的评估输血指征评分指导术中和术后患者红细胞输注的安全性和有效性。方法收集2017年12月~2021年3月的900例围术期Hb(60~100)g/L患者,男251例,女649例,ASAⅠ~Ⅳ级,随机分为评分组和指南组。评分组根据围术期输血指征评分的得分值启动输血Hb值,对照组由医师在指南框架内启动输血Hb值。记录输入异体红细胞的比例和量、术后并发症和死亡率、Hb值、手术切口愈合等级、ICU入住率和停留时间、住院时间等。结果红细胞输注比例评分组(35.3%)比指南组(42.2%)低(P<0.05);2组异体红细胞输注量、术后并发症和死亡率、手术切口愈合、术后24 h及出院的Hb值、ICU入住率及停留时间、住院时间等差异无统计学意义。结论输血指征评分指导围术期红细胞输注,可减少其使用率,安全有效。Objective To evaluate the safety and effectiveness of Perioperative Transfusion Trigger Score(POTTS)in guiding surgical patients blood transfusion intraoperatively and postoperatively.Methods A total of 900 patients(perioperative Hb 60~100 g/L)from December 2017 to March 2021 were collected,including 251 males and 649 females,with ASA gradingⅠ~Ⅳ,and randomly divided into experimental group and controls.In the experimental group,the allogeneic RBC transfusion trigger(Hb threshold)and transfusion units in anemia patients was determined by POTTS.While those in the controls were decided by physicians according to current guidelines concerning transfusion.The proportion and units of allogeneic RBC transfusion,the incidence of postoperative complications,the mortality of hospitalization and discharge for 4 weeks,Hb value,healing of surgical incision,ICU admission rate and ICU length of stay,length of hospitalization,etc were recorded.Results The proportion of allogeneic RBC transfusion in the experimental group(35.3%)were less than the controls(42.2%)(P<0.05).The units of allogeneic RBC transfused,incidence of postoperative complications and mortality in hospital and 4 weeks after surgery,healing of surgical incision(grade A/grade B/grade C),the Hb level 24 h after surgery and at discharge,the ICU admission rate and ICU length of stay,length of hospitalization were not significantly different between the groups.Conclusion The peri-operative allogeneic red blood cells transfusion guided by POTTS can reduce the proportion of allogeneic RBC transfusion,and is safe and effective.

关 键 词：围术期输血管理 围术期输血指征评分 异体红细胞 

分 类 号：R457.1[医药卫生—治疗学] R331.141[医药卫生—临床医学]