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目的通过观察ICU患者输注不同储存时间红细胞悬液后的临床效应,探讨适合这类特殊群体输血的血液要求,为其安全有效输血提供可靠的循证依据。方法选取西南医科大学附属医院ICU科,2014年1月1日-2014年12月30日,行红细胞输注治疗的符合条件的危重症患者423例纳入此次试验研究,对其输血疗效和预后进行病例回顾性研究。将纳入研究的患者分为2组,分别为输入平均红细胞储存时间<14 d组和输入平均红细胞储存时间≥14 d组。记录患者一般情况,入院诊断,ICU期间输注的RBC总量及次数,ICU期间输血前后的血红蛋白浓度,APACHEⅡ评分,机械通气时间,器官衰竭情况,ICU停留时间,院内感染情况,输血不良反应,住院总时间和死亡人数。统计资料符合正态分布的选用t检验,计数资料使用卡方检验。结果患者输血效果与患者APACHEII评分和输血量,血液储存时间密切相关,而与其年龄,性别,进出ICU的血红蛋白浓度,机械通气时间,ICU停留时间无明显关系。患者预后与血液储存时间有关,平均库血时间≥14 d患者和平均库血时间<14 d患者的院内感染率分别为6.3%和4.1%,器官衰竭分别为2.8%和1.4%,患者死亡率分别为9.6%和6.5%。结论输注红细胞平均储存时间≥14 d的ICU危重患者的院内感染率和死亡率,器官衰竭率升高,建议ICU危重患者使用储存时间<14 d的红细胞悬液。
Objective To observe the clinical effect of transfusion of erythrocytes suspension in different ICU patients during different storage time and to explore the blood requirements for blood transfusion in this special group so as to provide a reliable evidence base for its safe and effective blood transfusion. Methods Forty-three critically ill critically ill patients treated with erythrocyte infusion were enrolled in the ICU department of Affiliated Hospital of Southwest Medical University from January 1, 2014 to December 30, 2014. The trial included 423 critically ill critically ill patients, Case retrospective study. Patients enrolled in the study were divided into two groups: the mean storage time of erythrocytes <14 days, the mean storage time of stored erythrocytes> 14 days. Record the general situation of patients, admission diagnosis, total amount and times of RBC infused during ICU, hemoglobin concentration before and after transfusion in ICU, APACHEⅡscore, mechanical ventilation time, organ failure, ICU stay, nosocomial infection, adverse transfusion reactions, Total hospital stay and number of deaths. Statistical data in line with the normal distribution of the use of t test, count data using the chi-square test. Results The transfusion effect was closely related to APACHEII score, transfusion volume and blood storage time, but not to age, sex, hemoglobin concentration in ICU, duration of mechanical ventilation and ICU stay. The prognosis of patients was related to the time of blood storage. The mean nosocomial infection rates were 6.3% and 4.1% in patients with mean blood pool time ≥ 14 days and mean blood pooling time <14 days respectively, and organ failure was 2.8% and 1.4% respectively. The mortality rate Respectively 9.6% and 6.5%. CONCLUSIONS: Infection rates and mortality rates of nosocomial ICU critically ill patients with an average storage time of erythrocytes ≥ 14 days are associated with an increased rate of organ failure. It is recommended that critically ill patients in ICU use erythrocyte suspensions for <14 days of storage.