目的 回顾性分析心脏瓣膜置换术中自体血回输各项指标，为直视心脏瓣膜置换术中输注异体血提供参考。方法 回顾性分析2020年1月至2021年12月在本院行心脏瓣膜置换术且术中行自体血回输的180名患者资料，根据术中是否输注异体血分为异体输血组和无异体输血组，分别比较患者一般资料和术前术后24 h的临床检验指标。结果 多因素Logistic回归分析显示，年龄(OR=1。110，95％CI:1。058～1。165，P＜0。05)和术中体外循环时间(OR=1。062，95％CI:1。038～1。086，P＜0。05)是异体输血的危险因素，术前 Hb 含量(OR=0。910，95％CI:0。868～0。953，P＜0。05)是保护因素。异体输血组患者术前 24 h 的 RBC(4。16±0。73 vs 4。52±0。71)× 1012/L 和 Hb(120。94± 17。97 vs 136。57±19。33)g/L 比无异体输血组低，术后 24 h 的 RBC(3。51±0。53 vs 4。13±0。78)×1012/L、Hb(114。15± 11。68vs 124。79±14。96)g/L及血小板计数(124。28±32。11 vs 148。29±26。62)×109/L均低于无异体输血组，差异有统计学意义(P＜0。05)。结论 直视心脏瓣膜置换术中，年龄和术中体外循环时间是自体血回输中加输异体血的危险因素，术前Hb含量是保护因素，术前需评估患者指标对症治疗，减少术中异体血输注。
Autologous blood transfusion during heart valve replacement surgery:a retrospective study
Objective To retrospectively analyze the indexes of autologous blood transfusion during heart valve replace-ment,in order to provide reference for allogeneic blood transfusion during heart valve replacement surgery under direct vi-sion.Methods The data of 180 patients who underwent heart valve replacement in our hospital from January 2020 to De-cember 2021 were analyzed retrospectively.The patients were divided into allogeneic and non-allogeneic blood transfusion group based on whether allogeneic blood was transfused during the operation,and the general data and 24 hours pre-and post-operative clinical examination indexes were compared.Results Multivariate logistic regression analysis showed that age(OR=1.110,95％CI:1.058-1.165,P＜0.05)and intraoperative cardiopulmonary bypass time(OR=1.062,95％CI:1.038-1.086,P＜0.05)were risk factors for allogeneic blood transfusion,and preoperative Hb content(OR=0.910,95％CI:0.868-0.953,P＜0.05)was a protective factor.The RBC count(4.16±0.73 vs 4.52±0.71)× 1012/L and Hb(120.94± 17.97 vs 136.57±19.33)g/L at 24 hours preoperative in the allogeneic transfusion group were lower than those in the non-allogeneic transfusion group,and the RBC(3.51±0.53 vs 4.13±0.78)× 1012/L,Hb(114.15±11.68 vs 124.79±14.96)g/L and platelet count(124.28±32.11 vs 148.29±26.62)×109/L at 24 hours postoperative were significantly lower than those in the non-allogeneic transfusion group(P＜0.05).Conclusion Age and intraoperative cardiopulmonary bypass time are the risk factors for autologous and allogeneic blood transfusion during heart valve replacement under direct vision,and the pre-operative Hb content is a protective factor.It is necessary to evaluate the symptomatic treatment of patients before operation and reduce allogeneic blood transfusion.
万方数据
维普
