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目的分析本院严重烧伤的成年患者用血情况,探讨与输血量相关的因素及临床医师评估用血的特点,为合理用血提供参考依据。方法对本院烧伤科收治的38例重度、特重度烧伤患者病历进行回顾性调查分析,内容包括性别、年龄、烧伤面积、吸入性损伤、有无感染、手术部位、术中失血量、手术及非手术用血量等信息。结果此次调查的38例烧伤患者,总共输入悬浮红细胞384 U,血浆1 094 U,其中57.4%的悬浮红细胞、9.78%的血浆被用于围手术期。患者的手术次数、手术部位、术中失血量与围手术期悬浮红细胞输注量成正相关,相关系数r分别为0.723、0.606、0.581,P<0.05。42.6%的悬浮红细胞和90.21%的血浆为非手术用血,其中患者年龄、烧伤面积、血红蛋白值与悬浮红细胞输注量的相关系数r分别为0.744、0.684、0.326,P<0.05,而吸入性损伤、烧伤感染与悬浮红细胞的输注量的相关系数r分别为0.057、0.107,P>0.05。结论围手术期悬浮红细胞用量占到重度烧伤患者红细胞用血总量的57.4%,需要加强对重度烧伤患者围手术期的用血管理。临床医师在评估贫血患者是否需要输血治疗时,存在一定的随意性。患者的年龄、烧伤面积和血红蛋白值是医师决定患者输血量的重要因素。
Objective To analyze the blood situation of adult patients with severe burns in our hospital and explore the factors related to blood transfusion and the characteristics of blood used by clinicians to provide a reference for rational use of blood. Methods Retrospective analysis was performed on the medical records of 38 patients with severe and severe burns admitted to our department, including gender, age, area of burns, inhalation injury, presence or absence of infection, site of operation, intraoperative blood loss, operation and Non-surgical use of blood and other information. Results In the 38 patients who underwent this survey, a total of 384 U of suspended erythrocytes and 1 094 U of plasma were injected. Of these, 57.4% of the suspended erythrocytes and 9.78% of the plasma were used during the perioperative period. The number of operation, operation site and intraoperative blood loss were positively correlated with perioperative suspension of erythrocyte transfusion. The correlation coefficients r were 0.723,0.606,0.581 respectively, P <0.05.42.6% of the suspended erythrocytes and 90.21% of the plasma were Non-surgical blood, including patient age, area of burn, the value of hemoglobin and the amount of suspended erythrocyte transfusion r were 0.744,0.684,0.326, P <0.05, while inhalation injury, burn infection and the amount of suspended erythrocyte infusion The correlation coefficient r were 0.057,0.107, P> 0.05. Conclusion Perioperative use of suspended red blood cells accounts for 57.4% of the total blood use of erythrocytes in patients with severe burn. It is necessary to improve the perioperative management of blood in patients with severe burn. Clinicians have some discretion in assessing the need for transfusion therapy in patients with anemia. The patient’s age, area of burn, and hemoglobin value are important factors in the physician’s decision to transfuse patients.