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目的根据外科手术患者不同部位与疾病,制定外科手术备血策略。方法收集重庆市急救医疗中心2014年1月-2015年12月外科手术患者术前备血和术中用血数据,用SPSS 19.0对其进行分析,比较不同疾病的手术用血率。结果手术总用血率约为42.3%,不同手术部位与疾病患者手术用血率从高到低依次为失血性休克77.3%,颅脑损伤63.2%,心脏疾病56.5%,多发伤55.3%,肝胆损伤46.5%,骨折40.8%,胃肠道疾病39.1%,腹部损伤39.0%,车祸伤38.9%,锐器、钝器伤38.4%,颅内出血36.5%,动脉瘤30.4%,胸部损伤19.7%,食管癌、肺癌10.6%。结论外科手术患者备血,应根据手术部位与疾病、实际用血量和实际用血人数建立外科手术患者手术备血策略:用血百分比<30%的手术,不用备血;≥30%进行交叉配血,实际备血量根据患者具体情况而定,保证临床输血安全、合理、有效。
Objective According to surgical patients with different parts and diseases, develop surgical blood preparation strategy. Methods The data of preoperative blood and blood transfusions in surgical patients from January 2014 to December 2015 in Chongqing Emergency Medical Center were collected and analyzed by SPSS 19.0 to compare the surgical rates of different diseases. Results The total operation rate of blood was about 42.3%. The surgical rates of hemorrhage and hemorrhage were 77.3%, 63.2%, 56.5%, 55.3%, and hepatobiliary 46.5% of injuries, 40.8% of fractures, 39.1% of gastrointestinal diseases, 39.0% of abdominal injuries, 38.9% of traffic accidents, 38.4% of blunt trauma, 36.5% of intracranial hemorrhage, 30.4% of aneurysms, 19.7% of chest injuries, Cancer, lung cancer 10.6%. Conclusions Surgical blood preparation should be based on the surgical site and disease, the actual blood volume and the actual number of blood transfusions. Surgical blood transfusion strategy should be used in patients undergoing surgical operation: surgery with blood percentage <30%, without blood preparation, cross-over ≥30% With blood, the actual amount of blood reserve according to the specific circumstances of patients, to ensure that clinical transfusion safety, reasonable and effective.