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目的:探讨手术患者术中维持不同水平的血红蛋白(Hb)浓度对手术的效果、安全性及患者预后的影响作用。方法:采用随机数字表法将收治的符合美国麻醉医师协会(ASA)Ⅰ~Ⅱ级拟实施手术治疗的180例患者分为3组,每组60例,3组患者采用自体血回输以维持不同水平的术中Hb浓度,分别为A组100~120g/L,B组80~100g/L,C组70~80g/L,测定3组患者不同时间点相关指标的变化情况。结果:术中、术毕、术后24h时的红细胞(RBC)、Hb在3组患者间比较差异均有统计学意义(均P<0.05),RBC、Hb水平显著的降低较术中时刻、血乳酸值较术中时刻显著的提高(P<0.05);在术中、术毕时刻3组间Hb、RBC组间比较A组>B组>C组,差异有统计学意义(P<0.05)。各个时间点3组患者的pH值、MAP值比较差异无统计学意义(P>0.05)。3组患者的术中输血量、发热率组间比较结果为A组>B组>C组,且组间比较差异有统计学意义(P<0.05)。3组患者的切口感染率、切口延迟愈合率及住院时间比较差异无统计学意义(P>0.05)。结论:在手术中将患者的Hb水平控制在一个较低的水平,能够有效的减少术中输血量,降低输血不良反应,同时不会对患者的手术安全性、预后造成不良影响。
Objective: To investigate the effect of maintaining different levels of hemoglobin (Hb) in surgical patients on the efficacy, safety and prognosis of patients. Methods: One hundred and eighty patients admitted to ASA Class Ⅰ ~ Ⅱ were enrolled in this study. The patients were divided into three groups (n = 60 in each group). All three groups received autologous blood transfusion The intraoperative Hb concentrations at different levels were 100 ~ 120g / L in group A, 80 ~ 100g / L in group B and 70 ~ 80g / L in group C, respectively. The changes of related indexes at different time points were measured. Results: There were significant differences in RBC and Hb between the three groups (all P <0.05), RBC and Hb levels were significantly lower than those at intraoperative, (P <0.05). There was a significant difference between Hb and RBC groups at the time of operation and at the time of operation (A> B> C) (P <0.05) ). There was no significant difference in pH and MAP between the three groups at all time points (P> 0.05). The blood transfusion volume and the fever rate in the three groups were compared between group A, group B, and group C, and the difference between the two groups was statistically significant (P <0.05). There was no significant difference in incision infection rate, incision delayed healing rate and length of hospital stay among the three groups (P> 0.05). CONCLUSIONS: Controlling the Hb level of patients at a lower level during surgery can effectively reduce intraoperative blood transfusion, reduce the transfusion adverse reactions, and will not adversely affect the operation safety and prognosis of the patients.