作　　者： (潘毅俊）; (周皓君）; (王玲）; (张颖）; (朱星宇）; (吴江）;

机构地区： 上海交通大学医学院附属仁济医院输血科,上海200127

出　　处： 《中国输血杂志》 2017年第7期740-742,共3页

摘　　要： 目的分析产科不同病种与围术期输血需求的关系,探讨产科择期手术的术前备血方案,以利于合理安排用血计划。方法回顾上海交通大学医学院附属仁济医院产科2013年1月1日-2017年6月30日收治的16 232名择期手术病例,比较年龄、术前诊断、手术类型、术前备血量、术中用血量、超计划用血量、用血和超计划用血比例等,进行手术用血风险因素分析。结果 455名患者使用了1 610单位红细胞,分别占备血人次的2.80%和备血量的4.87%,151名患者手术中超计划使用了500单位红细胞,分别占用血人次的33.19%和用血量的31.06%,胎盘因素、异位妊娠、胎儿因素占用血人次比和用血量比的前三位,分别为32.32%和59.58%、6.52%和10.30%、5.88%和9.12%,均高于或接近平均值两倍。结论重视产前诊断与产科手术用血风险的关联,对于合理制订用血计划,指导术前血液准备,确保产科手术安全具有重要现实意义。 Objective Preoperative preparation of blood is common. The preoperative blood ordering and transfusion practices for elective obstetric surgery were evaluated in our Renji hospital in order to develop a reasonable preoperative blood preparation schedule for those procedures where a cross-match appears necessary. Methods We evaluated blood ordering practices in total 16 232 elective obstetric surgeries in our hospital from January 1, 2013 to June 30, 2017 retrospectively. The age of patients, preoperative diagnosis, surgical procedures type, preparation volume of blood, intra-operative transfu- sion volume of blood, and excessive usage ratio of blood were calculated and analyzed. Results 455 patients transfused intr- aoperatively total 1 610 U red blood ceils. The usage ratio of blood was 2. 80% for patients and 4. 87% for blood preparation volumes respectively.Placenta previa, ectopic pregnancy, twin pregnancy accounted for the first three of the possibility of in- traoperative blood transfusion in obstetric surgeries. Conclusion The relationship between preoperative diagnosis and the risk of blood transfusion in obstetric surgery should be take attention to. Preoperative blood typing, antibody screening and appropriate cross-matching could ensure the safety of obstetric surgery.

关 键 词： 产前诊断 术前备血 血液安全