围手术期综合血液管理在心脏手术中的应用

目的：探讨应用围手术期综合血液管理方法降低心脏手术中输血量的可行性和效果。方法：收集中山医院2015年9月—2016年3月接受心脏手术患者148例，分为对照组76例，采取常规管理；研究组72例（未输血48例，输血24例），采用围手术期综合血液管理。比较两组的主要临床指标，并采用多因素回归法分析影响输血的危险因素。结果：两组均无死亡病例。研究组输血率为33.33%，平均输血量327.08 ml；对照组输血率为67.11%，平均输血量608.55 ml；两组患者输血率差异有统计学意义（P＜0.05）。未输血组和输血组患者的性别、年龄、身高、体重、术前血红蛋白和血球压积、术后血红蛋白和血球压积差异均有统计学意义（P＜0.05）。多因素回归分析显示体重为输血的独立危险因素（P＜0.05）。结论：围手术期综合血液管理方法能有效降低心脏手术输血量。

Application of integrated perioperative blood management in cardiac surgery

Objective: To investigate the effect and feasibility of integrated perioperative blood management in cardiac surgery to reduce the amount of blood transfusion.Methods: A total of 148 patients, who underwent cardiac surgery in Zhongshan Hospital from September 2015 to March 2016, were enrolled and divided into two groups. The control group with 76 patients underwent routine procedure management, while the study group with 72 patients underwent integrated operative blood management. In the study grouop, 24 patients received blood transfusion and 42 patients didn’t. The major clinical indicators were compared between the two groups. And multi-factor regression was used to analyze the risk factors impacting on blood transfusion.Results: No perioperative death was found in both groups. The blood transfusion rate and average amount of blood transfusion was 33.3% and 327.08 ml in the study group, respectively. Meanwhile the blood transfusion rate and average amount of blood transfusion was 67.11% and 608.55 ml in the control group. There were signiifcant differences between two groups(P<0.05).The factors such as sex, age, body height and weight, preoperative hemoglobin and hematocrit, postoperative hemoglobin and hematocrit were signiifcantly different in non-transfusion patients and transfusion patients(P<0.05). Multi-factor logistic regression analysis suggested that the body weight was the independent risk factor related to blood transfusion(P<0.05). Conclusion: The application of integrated perioperative blood management is a beneifcial approach in reducing the amount of blood transfusion.