摘要
目的探讨神经外科手术患者术前备血及围术期用血情况,提出可行性的术前备血方案,并指导临床合理用血。方法选择首都医科大学宣武医院2019年1月1日至2020年1月1日神经外科2938例手术患者进行回顾性分析,根据实施手术类型将神经外科手术分为肿瘤组、脊椎病变组、血管病变组、颅脑损伤组和脑积水组5组,比较不同组别患者术前备血及围术期用血情况。结果不同组别中,血管病变组、颅脑损伤组和肿瘤组患者的出血量较多,脑积水组的患者出血量最少;手术患者总输血率为32.2%,其中仅自体血回输率为22.9%,仅异体血回输率为3.9%,自体联合异体输血率为5.3%;不同组别患者输血率不同,血管病变组输血率最高,为65.1%,脊椎病变组的输血率最低,为6.6%;不同组别患者台均备血量,比较差异无统计学意义(P>0.05),台均输血量组间比较,差异有统计学意义(P<0.05);不同组别中脊椎病变组的C/T值最高,为31.5,脑积水组C/T值最低,为1.6;脊椎病变组和肿瘤组的输血指数较低(≤0.3)。结论神经外科不同手术类型患者用血情况不同,部分手术术前用血评估过高,建议临床医生应根据手术类型及患者自身整体情况进行评估、备血及用血,适当降低不必要的备血量、提高血液预订和使用效率。
Objective To explore the situation of preoperative blood preparation and perioperative blood use of patients with different operations in neurosurgery,and to put forward feasible preoperative blood preparation plan and guide clinical rational blood use.Methods A total of 2938 neurosurgery patients from January 1,2019 to January 1,2020 in Xuanwu Hospital,Capital Medical University were analyzed.According to the type of operation,neurosurgeries were divided into 5 groups including tumor group,spinal lesion group,angiopathy group,crainocerebral injury group and hydrocephalus group.The preoperative blood preparation and perioperative blood use of patients with different groups were compared.Results Among the different types of operation,the bleeding volume of the patients in the angiopathy group,crainocerebral injury group and tumor group was higher,and the bleeding volume of the patients in the hydrocephalus group was the least.The total transfusion rate of the patients in the operation group was 32.2%,of which the rate of autologous blood transfusion alone was 22.9%,that of allogeneic blood transfusion alone was 3.9%,and that of autologous combined allogeneic blood transfusion was 5.3%.The transfusion rate of the patients in the different groups was different,the highest transfusion rate was 65.1%in the angiopathy group,and the lowest transfusion rate was 6.6%in the spinal lesion group.There was no difference in the mean blood volume of patients with different types of operation(P>0.05),and there was significant difference in the mean blood volume between groups,the difference was statistically significant(P<0.05).The highest C/T ratio was 31.5 in the spinal lesion group,and the lowest C/T ratio was 1.6 in the hydrocephalus group.The transfusion index was lower in the spinal lesion group and tumor group(≤0.3).Conclusion Different types of neurosurgery patients have different blood use conditions,and some preoperative blood use evaluation is too high.It is suggested that clinicians should evaluate,prepare and use blood according to the type of operation and the overall situation of patients,appropriately reducing unnecessary blood preparation and improving blood booking and use efficiency.
作者
杨菲菲
苑可欣
任伟
YANG Feifei;YUAN Kexin;REN Wei(Blood speciacty Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Capital Medical University,Beijing 100069,China;Department of Blood Transfusion,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《国际检验医学杂志》
CAS
2021年第14期1675-1678,共4页
International Journal of Laboratory Medicine
基金
首都医科大学2019年度本科生创新项目(XSKY2019132)。
关键词
神经外科手术
备血
输血
neurosurgery
blood preparation
blood transfusion
作者简介
杨菲菲,女,在读硕士研究生,主要从事血液/输血方面的研究;通信作者:任伟,E-mail:renwei_2006@163.com。
