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目的分析腹膜后肿瘤切除术围手术期临床用血,加强围手术期血液输注管理。方法回顾分析108例腹膜后肿瘤切除术患者围手术期临床用血情况,分析腹膜后肿瘤切除术围手术期临床用血合理性和特点。结果 108名患者围手术期输注异体血患者80名,异体血输血率74.00%;RBC、血浆、血小板输注率分别为74.00%、69.40%、12.04%;手术例均RBC、血浆、血小板输注量分别为10.30 U、953.70 mL、0.42 U;总自体输血率38.90%,例均自体采血量795.00 mL;108例腹膜后肿瘤患者围手术期不合理异体RBC输注9例,不合理异体RBC输注率为8.33%;术中出血量>500 mL“RBC过量输注”25例,占比23.15%;“RBC过量输注”患者术前Hb、Hct及术后1dHb、Hct水平明显高于无“RBC过量输注”患者,2组结果比较,P<0.01。结论腹膜后肿瘤切除术围手术期不合理RBC输注比例为8.33%;“RBC过量输注”率为23.15%,术前高Hb、Hct患者更易导致“RBC过量输注”;外科围手术期临床用血管理需进一步加强。
Objective To analyze perioperative clinical blood supply of retroperitoneal tumor resection and to strengthen perioperative blood transfusion management. Methods Retrospective analysis of 108 cases of peritoneal resection of patients with perioperative clinical blood use, analysis of peritoneal resection of retroperitoneal blood rationality and characteristics. Results The perioperative blood transfusion rate was 74.00% in all 108 patients. The rates of RBC, plasma and platelet transfusion were 74.00%, 69.40% and 12.04% respectively. The RBC, plasma and platelet transfusion The total volume of autologous blood transfusion was 38.90%, and the volume of autologous blood transfusion was 795.00 mL. Nine patients with peritoneal unreasonable allogeneic RBC infusion in 108 patients with retroperitoneal tumor and unreasonable allogeneic RBC Infusion rate was 8.33%; blood loss> 500 mL, “RBC over infusion” 25 cases, accounting for 23.15%; “RBC overfiltration” patients preoperative Hb, Hct and postoperative 1dHb, Hct The level was significantly higher than without “RBC over infusion” patients, two groups of results, P <0.01. Conclusion Perioperative RBC transfusion rate of peritoneal resection is 8.33%. The rate of RBC over infusion is 23.15%. Patients with high Hb and Hct before operation are more likely to cause RBC over infusion. Surgical perioperative clinical blood management needs to be further strengthened.