摘要
目的 探讨脊柱侧凸手术患儿术前补铁后血红蛋白(hemoglobin,Hb)水平与围手术期异基因输血(输血)需求的关系.方法 对2013 年 1 月～2020 年 12 月在该院接受手术治疗的 173 例＜18 岁脊柱侧凸患儿(术前均接受补铁治疗)的病历资料进行回顾性分析,记录患儿年龄、体重、性别、脊柱侧凸病因、初始Cobb角、融合椎体数量、手术时间、术中和术后红细胞输注的详细信息、输注的红细胞数量、术后住院时间、术前补充铁剂方案、术前血红蛋白和铁蛋白值,观察术前血红蛋白水平与围手术期输血的关系.结果 81 例接受术中输血,占46.82%.输血组和非输血组患儿年龄、体重、非特发性脊柱侧凸、Cobb角、椎体融合数、手术时间、铁疗法时间、术前血红蛋白水平、住院期间最低血红蛋白水平、自体血回输量、术后PICC、术后机械通气、住院时间等资料的差异均有统计学意义(P＜0.05).多因素Logistic回归分析显示,非特发性脊柱侧凸、Cobb角≥75°、椎体融合数量≥12 个是术中输血的风险因素(P＜0.05);血红蛋白 130～139 g/L、血红蛋白≥140 g/L是术中输血的保护性因素(P＜0.05).结论 术前血红蛋白≥130 g/L对于接受围手术期异基因输血具有保护作用,但补充铁剂的最佳剂量、持续时间等尚不明确,需要进一步研究探讨.
Abstract
Objective To investigate the relationship between the level of hemoglobin(Hb)after preoperative iron supplementa-tion and the demand for perioperative allogeneic blood transfusion(blood transfusion)in children with scoliosis.Methods The medi-cal records of 173 patients with scoliosis＜18 years old who underwent surgery in our hospital from January 2013 to December 2020 were analyzed retrospectively.The patients'age,body mass,gender,etiology of scoliosis,initial Cobb angle,number of fused verte-bral bodies,time,details of intraoperative and postoperative erythrocyte infusion,number of infused cells,postoperative hospital stay,preoperative iron supplement scheme,preoperative hemoglobin and ferritin values were recorded,and the relationship between preoper-ative hemoglobin level and perioperative blood transfusion was observed.Results Eighty-one cases received intraoperative blood trans-fusion,accounting for 46.82%.There were significant differences in age,body mass,non idiopathic scoliosis,Cobb angle,number of vertebral fusion,operation time,iron therapy time,preoperative hemoglobin,minimum hemoglobin during hospitalization,autologous blood reinfusion volume,postoperative PICC,postoperative mechanical ventilation and hospitalization time between the transfusion group and non transfusion group(P＜0.05).Multivariate logistic analysis showed that non idiopathic scoliosis,Cobb angle≥75°and the number of vertebral fusion≥12 were the risk factors for intraoperative blood transfusion(P＜0.05).Hemoglobin 130～139 g/L and hemoglobin≥140 g/L were the protective factors of intraoperative blood transfusion(P＜0.05).Conclusion Preoperative hemo-globin≥130 g/L has a protective effect on perioperative allogeneic blood transfusion,but the optimal dose and duration of iron supple-ment are not clear,which need to be further studied.
维普
万方数据