心脏瓣膜置换术中自体血回输的回顾性研究  

Autologous blood transfusion during heart valve replacement surgery:a retrospective study

作　　者：叶敏 李津杞 邱丽玲 钱宝华 YE min;LI Jinqi;QIU Liling;QIAN Baohua(The First Affiliated Hospital of the Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院输血科,上海200433

出　　处：《中国输血杂志》2024年第1期16-20,共5页Chinese Journal of Blood Transfusion

摘　　要：目的 回顾性分析心脏瓣膜置换术中自体血回输各项指标,为直视心脏瓣膜置换术中输注异体血提供参考。方法 回顾性分析2020年1月至2021年12月在本院行心脏瓣膜置换术且术中行自体血回输的180名患者资料,根据术中是否输注异体血分为异体输血组和无异体输血组,分别比较患者一般资料和术前术后24 h的临床检验指标。结果 多因素Logistic回归分析显示,年龄(OR=1.110,95%CI:1.058~1.165, P<0.05)和术中体外循环时间(OR=1.062,95%CI:1.038~1.086, P<0.05)是异体输血的危险因素,术前Hb含量(OR=0.910,95%CI:0.868~0.953, P<0.05)是保护因素。异体输血组患者术前24 h的RBC(4.16±0.73vs4.52±0.71)×1012/L和Hb(120.94±17.97vs136.57±19.33)g/L比无异体输血组低,术后24 h的RBC(3.51±0.53vs4.13±0.78)×1012/L、Hb(114.15±11.68vs124.79±14.96)g/L及血小板计数(124.28±32.11vs148.29±26.62)×109/L均低于无异体输血组,差异有统计学意义(P<0.05)。结论 直视心脏瓣膜置换术中,年龄和术中体外循环时间是自体血回输中加输异体血的危险因素,术前Hb含量是保护因素,术前需评估患者指标对症治疗,减少术中异体血输注。Objective To retrospectively analyze the indexes of autologous blood transfusion during heart valve replacement,in order to provide reference for allogeneic blood transfusion during heart valve replacement surgery under direct vision.Methods The data of 180 patients who underwent heart valve replacement in our hospital from January 2020 to December 2021 were analyzed retrospectively.The patients were divided into allogeneic and non-allogeneic blood transfusion group based on whether allogeneic blood was transfused during the operation,and the general data and 24 hours pre-and post-operative clinical examination indexes were compared.Results Multivariate logistic regression analysis showed that age(OR=1.110,95%CI:1.058-1.165,P<0.05)and intraoperative cardiopulmonary bypass time(OR=1.062,95%CI:1.038-1.086,P<0.05)were risk factors for allogeneic blood transfusion,and preoperative Hb content(OR=0.910,95%CI:0.868-0.953,P<0.05)was a protective factor.The RBC count(4.16±0.73 vs 4.52±0.71)×10^(12)/L and Hb(120.94±17.97 vs 136.57±19.33)g/L at 24 hours preoperative in the allogeneic transfusion group were lower than those in the non-allogeneic transfusion group,and the RBC(3.51±0.53 vs 4.13±0.78)×10^(12)/L,Hb(114.15±11.68 vs 124.79±14.96)g/L and platelet count(124.28±32.11 vs 148.29±26.62)×10^(9)/L at 24 hours postoperative were significantly lower than those in the non-allogeneic transfusion group(P<0.05).The RBC count and Hb at 24 hours preoperative in the allogeneic transfusion group were lower than those in the non-allogeneic transfusion group,and the Hb,RBC and platelet count at 24 hours postoperative were significantly lower than those in the non-allogeneic transfusion group(P<0.05).Conclusion Age and intraoperative cardiopulmonary bypass time are the risk factors for autologous and allogeneic blood transfusion during heart valve replacement under direct vision,and the preoperative Hb content is a protective factor.It is necessary to evaluate the symptomatic treatment of patients before operation and red

关 键 词：心脏瓣膜置换术 自体血液 血液回输 异体血液 

分 类 号：R457.1[医药卫生—治疗学]