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目的:调查分析围手术期限制性输血对骨科手术患者术后恢复的影响,为临床输血策略提供参考依据。方法:选择预计术中出血量>400ml的骨科手术患者768例,年龄34~67岁,术前血红蛋白浓度(Hb)≥110g/L,血细胞比容(Hct)≥35%,按ASA分为Ⅰ~Ⅲ级。根据不同输血策略将患者分为开放性输血组(Hb<100g/L输血、100~120g/L维持)351例与限制性输血组(Hb<80g/L输血、80~100g/L维持)417例。比较2组性别、年龄、体质量、ASA分级、术前Hb、手术时间、术中尿量及术后引流量等一般资料;观察并2组输血率、平均输血量、输血不良反应、麻醉苏醒时间及术后拆线时间。结果:12组患者性别、年龄、体质量、ASA分级、术前Hb、手术时间、术中尿量及术后引流量等一般资料比较,差异均无统计学意义(均P>0.05);2限制性输血组的输血率、平均输血量及输血不良反应发生率均显著低于开放性输血组(P<0.05),2组麻醉苏醒时间和术后拆线时间均无统计学差异(均P>0.05)。结论:骨科手术患者围手术期限制性输血可减少输血量和降低输血暴露风险,且不会对术后恢复造成不良影响。
Objective: To investigate the impact of perioperative restrictive blood transfusion on postoperative recovery of patients undergoing orthopedic surgery and provide reference for clinical transfusion strategies. Methods: A total of 768 orthopedic patients were enrolled in this study. Their ages were from 34 to 67 years. The preoperative hemoglobin concentration (Hb) ≥110 g / L and hematocrit (Hct) ≥35% ~ Ⅲ grade. The patients were divided into open transfusion group (Hb <100g / L transfusion, maintenance of 100-120g / L) and restriction transfusion group (Hb <80g / L transfusion, maintenance of 80-100g / L) according to different transfusion strategies. example. The general data such as sex, age, body weight, ASA classification, preoperative Hb, operation time, intraoperative urine output and postoperative drainage were compared. The blood transfusion rate, mean blood transfusion, adverse transfusion reactions, Time and postoperative stitches time. Results: There was no significant difference in the general data of gender, age, body weight, ASA classification, preoperative Hb, operation time, intraoperative urine output and postoperative drainage among 12 groups of patients (all P> 0.05); 2 The blood transfusion rate, mean blood transfusion and the incidence of adverse transfusion reactions in the restricted transfusion group were significantly lower than those in the open transfusion group (P <0.05). There was no significant difference between the two groups in anesthesia recovery time and postoperative stitching time > 0.05). CONCLUSIONS: Perioperative blood transfusions in patients undergoing orthopedic surgery reduce the amount of blood transfusions and the risk of transfusion exposure without adversely affecting postoperative recovery.