在成年脊柱形手术中,全源红细胞输血的危险因素
Yasushi Iijima1, Toshiaki Kotani1, Tsuyoshi Sakuma1
1Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
Asian spine journal
|August 20, 2024
概括
在成年脊柱形手术中尽量减少全源红细胞输血,需要仔细考虑手术内血酸 (TXA) 和自身献血. 长时间的手术也会增加输血风险.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 麻醉学 麻醉学
- 输血医学 输血医学
背景情况:
- 全基红细胞 (RBC) 输血在成人脊柱形 (ASD) 手术中很常见.
- 影响输血风险的因素,如手术内低温症,自身献血和静血剂,需要进一步调查.
研究的目的:
- 在成年脊柱形 (ASD) 手术中确定异构红细胞输血的危险因素.
- 了解各种外科手术期间因素对输血需求的影响.
主要方法:
- 对151名接受ASD纠正手术的成年患者 (2012-2021) 的回顾性审查.
- 后勤回归分析,以评估患者人口统计学,手术因素和干预措施对输血率的影响.
- 对那些接受过全基血输血的患者与没有接受过全基血输血的患者进行比较.
主要成果:
- 47%的患者接受了全基性输血 (平均输血:994.2毫升).
- 输血的独立预测因素包括:没有手术内转血酸 (TXA) (OR 26.3),没有自主献血 (OR 21.2) 和延长的手术时间 (OR 1.6).
结论:
- 自主献血和手术内TXA的使用对于在ASD手术中减少外科手术期间全原红细胞输血至关重要.
- 应优先考虑尽量减少输血的策略,特别是对于接受长时间手术的患者.
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