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目的分析产科不同病种与围术期输血需求的关系,探讨产科择期手术的术前备血方案,以利于合理安排用血计划。方法回顾上海交通大学医学院附属仁济医院产科2013年1月1日-2017年6月30日收治的16 232名择期手术病例,比较年龄、术前诊断、手术类型、术前备血量、术中用血量、超计划用血量、用血和超计划用血比例等,进行手术用血风险因素分析。结果 455名患者使用了1 610单位红细胞,分别占备血人次的2.80%和备血量的4.87%,151名患者手术中超计划使用了500单位红细胞,分别占用血人次的33.19%和用血量的31.06%,胎盘因素、异位妊娠、胎儿因素占用血人次比和用血量比的前三位,分别为32.32%和59.58%、6.52%和10.30%、5.88%和9.12%,均高于或接近平均值两倍。结论重视产前诊断与产科手术用血风险的关联,对于合理制订用血计划,指导术前血液准备,确保产科手术安全具有重要现实意义。
Objective To analyze the relationship between different obstetric diseases and perioperative blood transfusion requirements and discuss the preoperative blood preparation plan of elective surgery in obstetrics to facilitate the rational arrangement of blood plan. Methods A retrospective review of 16 232 elective surgery cases admitted to Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 1, 2013 to June 30, 2017 was conducted. The age, preoperative diagnosis, type of surgery, preoperative blood volume, Intraoperative blood, ultra-plan use of blood, blood and ultra-plan for the proportion of blood, blood risk factors for surgical analysis. Results 455 patients used 1 610 units of erythrocytes, accounting for 2.80% of the total number of prepared blood and 4.87% of the total amount of prepared blood, respectively. Out of the 151 patients, 500 units of erythrocytes were planned for surgeries, accounting for 33.19% 31.06%, placental factors, ectopic pregnancy, fetus factor occupancy ratio of blood and blood than the first three were 32.32% and 59.58%, 6.52% and 10.30%, 5.88% and 9.12%, respectively, higher than Or nearly double the average. Conclusion The emphasis on the association between prenatal diagnosis and blood risk of obstetric surgery is of great practical significance for the rational development of blood plan, preoperative blood preparation and ensuring the safety of obstetric surgery.