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目的调查髋关节置换术输血的合理性,从而提高医院临床用血的管理。方法某院2016年1月-2月髋关节置换术10例患者的输血情况。患者均采用腰硬联合麻醉和单侧股骨头置换术。术中常规使用血液回收机,术终回输自体RBCs。术后输血与否和输RBCs单位数均由骨科医师决定。输血合理性分为三类:(1)零输血;(2)合理输血;(3)欠合理输血。结果 2例为零输血,4例为合理输血,4例为欠合理输血。4例欠合理输血中,1例因输1U RBCs后发生寒战而终止输血,术后Hb为117g/L,属于超输。结论髋关节置换术应减少不必要的输血。术前Hb>120g/L者可免输血,Hb<120g/L者需合理输血。术后Hb在80g-90g/L之间是安全的。
Objective To investigate the rationality of blood transfusion in hip arthroplasty to improve the management of clinical blood in hospital. Methods A hospital from January 2016 to February 2016 hip replacement surgery in 10 cases of blood transfusion. Patients were treated with spinal anesthesia and unilateral femoral head replacement. Intraoperative routine use of blood collection machines, surgery and autologous transfusions of RBCs. Postoperative blood transfusion or not and lose RBCs units are determined by the orthopedic surgeon. Transfusion rationality is divided into three categories: (1) zero blood transfusion; (2) reasonable blood transfusion; (3) owed a reasonable blood transfusion. Results 2 cases of zero blood transfusion, 4 cases of a reasonable blood transfusion, 4 cases owed a reasonable blood transfusion. In 4 cases of unreasonable blood transfusions, 1 patient died of shivering after losing 1U of RBCs, and the postoperative Hb was 117g / L, which belonged to superovulation. Conclusions Hip replacement should reduce unnecessary transfusions. Preoperative Hb> 120g / L can be blood transfusion, Hb <120g / L who need a reasonable blood transfusion. Postoperative Hb between 80g-90g / L is safe.