心脏手术输血方式的探讨

来源 :中国输血杂志 | 被引量 : 0次 | 上传用户:fionazj
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目的分析探讨本院择期心脏手术患者输血方式及异体血输注量差异,为今后的临床工作提供一定的参考信息。方法搜集本院2016年1月1日-12月31日共计115例获得明确临床诊断的心脏手术患者的临床输血资料,分析其性别、年龄、血型、病种的分布情况,并对其输血方式和各种异体成分血的输注情况进行回顾性的统计分析。结果 115例术中输血的心脏手术患者中,81例患者应用自体输血,方式均为术中回收式,其中76例亦有异体血输注,5例仅输注自体血;34例术中仅输注异体血。术中应用自体输血的患者年龄明显高于无自体输血者,有自体输血者以冠状动脉硬化性心脏病(冠心病)和风湿性心脏瓣膜病(风心病)居多,其手术风险大,多是2种输血方式并用,其中,冠心病手术患者男性明显多于女性;术中没有自体输血的患者多是先天性心脏病(先心病)的儿童,其术中异体血的输注量明显低于老年心脏手术患者。各个血型间平均用血量无显著差异,不同病种间各成分血平均用量可见显著差异。结论心脏手术多数需要施行体外循环,操作时间长,出血量多,因此用血量很大,应根据病种做好术前备血工作,并积极开展自体输血等血液保护措施。 Objective To analyze the differences of blood transfusion and allogeneic blood transfusion in patients undergoing elective cardiac surgery in our hospital and provide some reference information for future clinical work. Methods A total of 115 clinical transfusion patients were enrolled in our hospital from January 1, 2016 to December 31, 2016, and their gender, age, blood type and disease type were analyzed. The blood transfusion method And a variety of allogenic blood transfusion for retrospective statistical analysis. Results Of the 115 patients undergoing cardiac surgery with transfusions, 81 patients underwent autologous blood transfusion, all of whom received intraoperative reclamation. Of these, 76 received allogeneic blood transfusions and 5 received autologous blood transfusions only; 34 received intraoperative blood transfusions only Allogeneic blood transfusion. Patients with autologous blood transfusion during surgery were significantly older than those without autologous blood transfusion. Most patients with autologous blood transfusion were coronary heart disease (CHD) and rheumatic heart disease 2 kinds of blood transfusion and use, of which, coronary heart surgery patients were significantly more men than women; no autologous blood transfusions in patients with mostly congenital heart disease (CHD) in children, the intraoperative blood volume was significantly lower Elderly cardiac surgery patients. There was no significant difference in mean blood consumption among different blood types. Significant differences were found in the average dosage of blood among different diseases. Conclusion The majority of cardiac surgery need extracorporeal circulation, long operation time and large amount of bleeding. Therefore, the amount of blood used is large. Preoperative blood preparation should be performed according to the disease type and blood protection measures such as autologous blood transfusion should be actively carried out.
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