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目的回顾分析本院妇科全子宫切除术的临床病例资料,总结全子宫切除术输血治疗现状和特点。方法收集2014-2017年在本院行妇科全子宫切除术的病例,统计其中围术期输血病例,分析不同术中出血量、不同手术方式等输血情况及特点,比较组别间输注红细胞的量及输血前后指标变化。结果本院全子宫切除术患者输血率20.1%,术前输血量占66.3%,平均红细胞输注量(3.8±1.9)U,平均红细胞输注量术前>术中>术后且差异具有统计学意义。输血病例不同术中出血量平均RBC输注量差异无统计学意义。不同Hb指征的比较:输血率、术前输血率及术前输血量,Hb<80 g/L组最高,差异有统计学意义。不同手术方式比较:术中出血量以开腹全切最多,腹腔镜全切次之,阴式切除最少;术中后输血率有差异,术中术后平均RBC输注量无差异。不同输血量的比较:各组之间输血前后Hb差值比较,差异具有统计学意义。结论我院全子宫切除术输血指征把握较好,输血疗效较好;应选择恰当手术方式,积极开展微创手术,减少异体血输注。
Objective To review the clinical data of gynecological hysterectomy in our hospital and summarize the current situation and characteristics of hysterectomy transfusions. Methods The cases of gynecological total hysterectomy in our hospital from 2014 to 2017 were collected, the cases of perioperative blood transfusion were collected, the blood transfusion status and different surgical methods were analyzed, and the transfusion of red blood cells The amount of blood transfusion before and after changes in indicators. Results The total hysterectomy patients with blood transfusion rate of 20.1%, preoperative blood transfusion accounted for 66.3%, the average amount of red blood cell transfusion (3.8 ± 1.9) U, the average amount of red blood cell transfusion preoperative> intraoperative> postoperative and statistical differences Significance of learning. There was no significant difference in average RBC transfusion between different intraoperative blood transfusion cases. Different Hb indications: blood transfusion rate, preoperative blood transfusion and blood transfusion, Hb <80 g / L group was the highest, the difference was statistically significant. Comparison of different surgical methods: intraoperative blood loss to open the whole cut the most laparoscopic cut, vaginal resection at least; postoperative blood transfusion rates were different intraoperative postoperative average RBC infusion was no difference. Comparison of different transfusion volume: Hb difference before and after transfusion between groups, the difference was statistically significant. Conclusion Hysterectomy in our hospital blood transfusion better grasp of indications, blood transfusion better; should choose the appropriate surgical approach, and actively carry out minimally invasive surgery to reduce allogeneic blood transfusion.