心脏瓣膜置换术围术期异体红细胞输注情况分析  

Analysis of allogeneic red blood cell infusion during perioperative period heart valve replacement

作　　者：邓波 谢弢[2] 王敏 夏英[1] 杨眉 黄海[1] DENG Bo;XIE Tao;WANG Min;XIA Ying;YANG Mei;HUANG Hai(School of Medical Laboratory Science,Guizhou Medical University,Guiyang,Guizhou 550001,China;Department of Blood Transfusion,Guizhou Provincial People's Hospital,Guiyang,Guizhou 550002,China)

机构地区：[1]贵州医科大学医学检验学院,贵州贵阳550001 [2]贵州省人民医院输血科,贵州贵阳550002

出　　处：《国际检验医学杂志》2023年第6期661-665,共5页International Journal of Laboratory Medicine

基　　金：贵州省创新人才资助项目(2019-5610)。

摘　　要：目的分析心脏瓣膜置换术围术期异体红细胞输注情况,为后续实施精准输血提供数据支持。方法选取2019年1月至2020年1月贵州省人民医院进行择期心脏瓣膜置换术的心脏瓣膜疾病患者492例作为研究对象,统计围术期术中和术后两个时期异体红细胞输注量情况和相关数据并进行多因素回归分析,筛选两个时期异体红细胞输注量的相关影响因素。结果术后时期人均异体红细胞输注量(3.27 U)明显高于术中时期(2.91 U)。将患者术中、术后时期异体红细胞输注量分别作为因变量,将单因素分析及相关性分析中有统计学意义的变量作为自变量,构建多重性回归模型,结果显示术中失血量、术前血红蛋白、体重指数(BMI)、体外循环时间和年龄是术中时期异体红细胞输注量的影响因素(P<0.05);术中失血量、心包引流量、重症监护室停留时间、住院时间、BMI和切口愈合不良是术后时期异体红细胞输注量的影响因素(P<0.05)。结论心脏瓣膜疾病患者围术期异体红细胞决策影响因素众多,根据分析相关有效因素,提前制定个体化用血方案,有助达到精准有效的输血疗效。Objective To analyze the transfusion of allogeneic red blood cells during perioperative period heart valve replacement,and to provide data support for accurate blood transfusion.Methods A total of 492 patients with heart valve disease who underwent elective heart valve replacement in Guizhou Provincial People′s Hospital from January 2019 to January 2020 were selected as the research objects.The transfusion of allogeneic red blood cells and related data during perioperative and postoperative periods were analyzed and multivariate regression analysis was performed to screen the related influencing factors of the amount of allogeneic red blood cells transfused during the two periods.Results The amount of allogeneic red blood cells transfused per capita in the postoperative period(3.27 U)was significantly higher than that in the intraoperative period(2.91 U).The amount of allogeneic red blood cells transfused in the intraoperative and postoperative were taken as dependent variables,and the statistically significant variables in univariate analysis and correlation analysis were taken as independent variables to establish a multiple regression model.The results showed that intraoperative blood loss,preoperative hemoglobin,body mass index(BMI),extracorporeal circulation time and age were the influencing factors of the amount of allogeneic red blood cells transfused in the intraoperative period(P<0.05).Intraoperative blood loss,pericardial drainage volume,length of stay in intensive care unit,length of hospital stay,BMI and poor incision healing were the factors influencing the amount of allogenic red blood cell infusion during the postoperative period(P<0.05).Conclusion Strengthening perioperative period blood use management and making individualized blood use plan in advance can effectively reduce the transfusion amount of allogeneic red blood cells after heart valve replacement.

关 键 词：心脏瓣膜置换术 围术期 异体红细胞输注 

分 类 号：R446.6[医药卫生—诊断学]