外科手术中自体血回输与异体血输注治疗费用的调查  

Investigation on fee of autologous blood transfusion and allogeneic blood transfusion in surgical operation

作　　者：杨敏利 罗恒 张若涵 Yang Minli;Luo Heng;Zhang Ruohan(Plastic Surgery Room,First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,Shaanxi Province,China;Surgical Operating Room,First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,Shaanxi Province,China;Department of Hepatobiliary,Pancreatic and Spleen Surgery,First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,Shaanxi Province,China)

机构地区：[1]空军军医大学第一附属医院整形手术室,西安710032 [2]空军军医大学第一附属医院外科手术室,西安710032 [3]空军军医大学第一附属医院肝胆胰脾外科,西安710032

出　　处：《国际输血及血液学杂志》2022年第6期531-537,共7页International Journal of Blood Transfusion and Hematology

基　　金：国家自然科学基金(81702329)。

摘　　要：目的探讨自体血回输在外科手术输血治疗中的价格优势。方法选择2019年1月至6月于空军军医大学第一、二附属医院和西安交通大学第一附属医院行外科手术时,接受输血治疗的185例患者为研究对象。患者年龄为(46.6±4.3)岁,男、女性患者分别为97和88例,接受肝移植、脾切除术和肝破裂修补术者分别为46、55和84例。根据患者的术中输血情况,将其分为自体血回输组(n=60),洗涤红细胞(WRBC)异体血输注组(n=61),去白细胞悬浮红细胞(LPRBC)异体血输注组(n=64)。根据《陕西省城市公立医院医疗服务项目价格(2017年版)》和陕西省中心血站供应血液价格收费标准相关规定,计算3组患者的输血治疗费用。采用回顾性研究方法,收集所有患者的一般人口学资料和输血相关临床资料,并且分析3组患者的手术输血治疗费用。患者输血治疗费用与输血量之间的线性关系分析,采用直线回归分析。3组患者的输血治疗费用的总体比较,采用单因素方差分析;组间两两比较,采用LSD-t检验。3组患者年龄,性别和手术类型构成比分别比较,差异均无统计学意义(P>0.05)。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求。结果①自体血回输组、WRBC异体血输注组和LPRBC异体血输注组患者的输血量分别为300~1800、244~1440和240~1440 mL,治疗费用分别为1325~1430、629~3659和609~3539元,3组患者的输血量与治疗费用均呈良好的线性关系(r=0.992、0.999、0.999,P<0.001);当患者的WRBC和LPRBC异体血输注量分别超过514和531 mL时,其输血治疗费用超过自体血回输。②3组患者中,接受600~720、720~960、960~1200、1200~1440 mL输血量治疗者的输血治疗费用分别比较,差异均有统计学意义(F=105.460、101.122、110.925、121.041,P<0.001);自体血回输组的治疗费用分别为(1356±87)元、(1301±105)元、(1387±132)元、(1335±187)元,均分别低于LPRBCObjective To explore price advantage of autologous blood transfusion in intraoperative blood transfusion.Methods From January to June 2019,a total of 185 patients who received blood transfusion during surgical operations in the First Affiliated Hospital of Air Force Military Medical University,the Second Affiliated Hospital of Air Force Military Medical University,or the First Affiliated Hospital of Xi'an Jiaotong University were selected as the study subjects.The patients were(46.6±4.3)years old.And there were 97 males and 88 females,and 46,55 and 84 cases underwent liver transplantation,splenectomy and liver rupture repair,respectively.According to intraoperative blood transfusion,these patients were divided into autologous blood transfusion group(n=60),washed red blood cells(WRBC)allogeneic transfusion group(n=61),and leukocyte poor red blood cells(LPRBC)allogeneic transfusion group(n=64).According to the relevant provisions of the Medical Service Project Price of Urban Public Hospitals in Shaanxi Province(2017 Edition)and the blood supply price and fee standard of Central Blood Stations in Shaanxi Province,the blood transfusion treatment fee of patients in 3 groups were calculated.A retrospective study was conducted to collect the general demographic data and transfusion related clinical data of all patients,and to analyze the fee of surgical transfusion treatment in the 3 groups.The linear relationship between fee and volume of blood transfusion was analyzed by linear regression.The overall comparison of blood transfusion treatment fees among the three groups was performed by one-way analysis of variance;LSD-t test was used for pairwise comparison between groups.There was no statistical significance in composition ratios of age,gender and type of surgery among the 3 groups(P>0.05).The procedure followed in this study is in accordance with the Declaration of Helsinki of the World Medical Association revised in 2013.Results①The blood transfusions volume in autologous blood transfusion group,WRBC allogeneic

关 键 词：输血 输血 自体 外科手术 费用 医疗 输血 异体血输注 

分 类 号：R61[医药卫生—外科学] R457.1[医药卫生—临床医学]