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目的了解先天性心脏病患儿术中输血的特点、术中输血的影响因素,筛选适用于临床术前评估患儿输血风险的指标,以期为患儿提供精细化输血治疗。方法回顾性分析2015年1-2月份于北京安贞医院小儿心脏外科行先天性心脏病手术的患儿病历资料300例。按照年龄分组:0-12M组,1-3岁组,3岁以上组。将可疑的影响因素进行组间比较后,将有统计学意义的影响因素进行多因素logistic回归分析,筛选各组患儿输血的影响因素。结果300例患儿中,238例接受术中输血治疗,输血率为79.33%。0-12M组输血率为95.45%;1-3岁组输血率为82.02%;3岁以上输血率为29.82%。logistic分析显示,0-12M组,体术前血红蛋白浓度是该组患儿输血的影响因素;1-3岁组,年龄、术前血红蛋白浓度是该组患儿输血的影响因素;3岁以上组,体重、术中出血量是该组患儿输血的影响因素。结论结合先心病患儿的用血特点及各年龄组输血影响因素,可综合评估患儿术中输血风险,实现患儿术前个性化备血方案。
Objective To understand the characteristics of intraoperative blood transfusion in children with congenital heart disease, intraoperative blood transfusion factors, screening for clinical preoperative assessment of transfusion risk indicators in order to provide children with meticulous transfusion therapy. Methods A retrospective analysis of 300 cases of pediatric history data of children with congenital heart disease undergoing pediatric cardiac surgery in Beijing Anzhen Hospital from January to February in 2015 was retrospectively analyzed. According to age group: 0-12M group, 1-3 years old group, 3 years old group. The suspicious factors were compared between groups, the statistically significant influencing factors were multivariate logistic regression analysis to screen the influencing factors of blood transfusion in each group. Results Of the 300 children, 238 received intraoperative blood transfusions, with a blood transfusion rate of 79.33%. The blood transfusion rate in 0-12M group was 95.45%, the transfusion rate in group 1-3 was 82.02%, and the transfusion rate was 29.82% over 3 years. Logistic analysis showed that the preoperative hemoglobin concentration in 0-12M group was the influencing factor of transfusion in children of this group. The 1-3 year old group, age and preoperative hemoglobin concentration were the influencing factors of transfusion in this group. , Body weight, intraoperative blood loss is the influencing factor of blood transfusion in this group. Conclusion Combined with the characteristics of blood in children with CHD and the influencing factors of blood transfusion in all age groups, we can comprehensively evaluate the transfusion risk in children and realize the preoperative personalized blood preparation plan.