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目的分析手术患者术前用血计划与术中实际输血量符合率,为术前制订科学合理有效的用血计划提供理论依据。方法通过对2011年1月1日-2013年12月30日本院手术患者围手术期输血情况进行回顾性调查,统计3年间用血量比较大的手术用血情况,以全髋关节置换术为例统计计划量与实际用血量的差异,采用t检验方法分析评价其符合性。结果 1)手术输血患者占手术患者比例逐年降低,手术患者人均红细胞输注量逐年降低。2)用血比例较大的几类手术3年间手术中红细胞输注量差异不具统计学意义(P>0.05)。3)超计划输血占总手术用血人次的16.3%,超计划用血患者计划血量与实际用血量差异具统计学意义(P<0.05)。4)股骨头缺血性坏死、股骨颈骨折、其他髋关节病变所致全髋关节置换术患者红细胞术前计划量与术中实际用血量分别为:2.97±1.01 U,4.77±2.33 U;3.26±0.99 U,5.42±3.91 U;3.16±1.07 U,6.08±4.80 U,计划量与实际输注量差异均具统计学意义(P<0.05)。结论术前制订有效的用血计划非常必要,对保障输血安全、手术安全意义重大,应尽量避免超计划用血,杜绝无计划用血,在综合评估患者个体情况下,术前红细胞用血计划可参考该类手术最近3年平均用血量。
Objective To analyze the coincidence rate of preoperative blood plan and actual intraoperative blood transfusion in surgical patients and to provide a theoretical basis for prescribing a scientific and rational blood plan. Methods The data of perioperative blood transfusion in our hospital from January 1, 2011 to December 30, 2013 were retrospectively analyzed. Surgical blood was collected with relatively large amount of blood during 3 years. Total hip arthroplasty Cases of statistical planning and actual use of blood differences, using t test analysis and evaluation of compliance. Results 1) The proportion of patients who underwent surgical transfusion decreased year by year, and the per capita amount of RBC decreased year by year. 2) There was no significant difference in the amount of erythrocyte transfusion between the three types of surgery with large proportion of blood (P> 0.05). 3) The transplanted blood transfusion accounted for 16.3% of the total number of surgical blood transfusions, and there was statistical significance (P <0.05) between the planned blood transfusion and the actual blood transfusion. 4) The amount of preoperative erythrocyte plan and actual blood volume in patients with total hip arthroplasty due to other femoral head avascular necrosis and femoral neck fracture were 2.97 ± 1.01 U and 4.77 ± 2.33 U, respectively; 3.26 ± 0.99 U, 5.42 ± 3.91 U, 3.16 ± 1.07 U and 6.08 ± 4.80 U, respectively. There was significant difference between planned and actual infusions (P <0.05). Conclusion It is very necessary to make an effective blood plan before operation. It is of great significance to ensure blood transfusion safety and surgical safety. Ultra-plan blood use should be avoided to avoid unplanned use of blood. In the comprehensive assessment of individual patients, Can refer to the average blood volume of the last 3 years of such surgery.