225例地震伤外科手术用血调查
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摘要
目的调查四川大学华西医院救治汶川地震伤员手术用血情况。方法收集2008年5月12日—6月30日在四川大学华西医院进行手术治疗的地震伤员的输血原始发血单,记录其性别、年龄、手术名称、输血量、输血时间。结果因手术需要,手术前、中、后24h输入红细胞悬液(RBC)或新鲜冰冻血浆(FFP)的地震伤员共有225名,年龄1—87岁;用血量:RBC为1163U、FFP为124500ml。输入RBC≤2U者占手术总人数的40.89%(为总量的14.4%),2.5—4U者占27.56%(19.7%),4.5—10U者占24.89%(32.5%),RBC>10U者占6.67%(33.4%)。输入FFP100—400ml者占44.89%(26.87%),450—1000ml者占18.22%(24.02%),>1000ml者占9.33%(49.12%),另有27.56%的地震伤员未使用FFP。FFP输入量与RBC输入量具有明显的相关性(R2=0.8547,P<0.05)结论华西医院地震伤员手术用血属于少量或中等量用血,相对于RBC用量而言,FFP的用量可能偏多,规范血浆的使用,提供快速有效的检测方法将是血液保护工作的一个重点。
Objective To investigate the blood transfusion in 255 Wenchuan earthquake victims who were operated in our hospital.Methods The original blood dispatching records of the earthquake injuries, from 12th May to 30th June, were collected. And the gender, age, surgical category, volume of blood transfusion, and the time of blood transfusion of the injuries were recorded.Results A total of 225 surgery-needed injuries, aged from 1—81 years old, received RBC transfusion and/or FFP transfusion before, during, and 24h after the operation. The total amount of RBC and FFP transfused were 1163U and 124 500ml, respectively. The percentages of patients, who received RBC≤2 U, RBC 2.5—4 U, RBC 4.5—10 U, and RBC>10 U, was 40.89%, 27.56%, 24.89%, and 6.67%, respectively. And the amount of RBC received by the aforementioned four groups accounted for 14.4%, 19.7%, 32.5%, and 33.4% of the total, respectively. The percentage of patients, who received FFP 100—400 ml, FFP 450—1 000 ml, and FFP >1 000 ml, was 44.89%, 18.22% and 9.33%, respectively, and the other 18.22% patients didn't received any FFP transfusion. And the amount of FFP received by the aforementioned three groups accounted for 26.87%, 24.02%, and 49.12% of the total, respectively. The total transfusion amount of RBC was significantly correlated with that of FFP (R2=0.8547, P<0.05).Conclusion The amount of blood transfusion received by the earthquake injuries is of low or medium level in our hospital. The transfusion amount of FFP is somewhat larger than that of RBC. And the reasonable use of FFP and the availability of quick detection methods would become a key point in the blood conservation.
Objective To investigate the blood transfusion in 255 Wenchuan earthquake victims who were operated in our hospital.Methods The original blood dispatching records of the earthquake injuries, from 12th May to 30th June, were collected. And the gender, age, surgical category, volume of blood transfusion, and the time of blood transfusion of the injuries were recorded.Results A total of 225 surgery-needed injuries, aged from 1—81 years old, received RBC transfusion and/or FFP transfusion before, during, and 24h after the operation. The total amount of RBC and FFP transfused were 1163U and 124 500ml, respectively. The percentages of patients, who received RBC≤2 U, RBC 2.5—4 U, RBC 4.5—10 U, and RBC>10 U, was 40.89%, 27.56%, 24.89%, and 6.67%, respectively. And the amount of RBC received by the aforementioned four groups accounted for 14.4%, 19.7%, 32.5%, and 33.4% of the total, respectively. The percentage of patients, who received FFP 100—400 ml, FFP 450—1 000 ml, and FFP >1 000 ml, was 44.89%, 18.22% and 9.33%, respectively, and the other 18.22% patients didn't received any FFP transfusion. And the amount of FFP received by the aforementioned three groups accounted for 26.87%, 24.02%, and 49.12% of the total, respectively. The total transfusion amount of RBC was significantly correlated with that of FFP (R2=0.8547, P<0.05).Conclusion The amount of blood transfusion received by the earthquake injuries is of low or medium level in our hospital. The transfusion amount of FFP is somewhat larger than that of RBC. And the reasonable use of FFP and the availability of quick detection methods would become a key point in the blood conservation.
引文
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[4]American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies.Practiceguidelines for perioperative blood transfusion and adjuvant therapies;an updated report by the American Sociely of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies[J].Anes-thesiology,2006,105(2),198—208
[2]刘斌,王泉云,宋跃明,等.全自动自体血液回收系统在脊柱外科手术中的应用[J].中华麻醉学杂志,1999,19(10):632—633
[3]康鹏德,裴福兴,龚全,等.胸腰椎爆裂骨折前路手术中自体血回输[J].中华创伤骨科杂志,2005,5(5):433—438
[4]American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies.Practiceguidelines for perioperative blood transfusion and adjuvant therapies;an updated report by the American Sociely of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies[J].Anes-thesiology,2006,105(2),198—208
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