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| 自体输血对创伤性颅脑损伤患者术后并发症及转归的影响 |
| Effect of autologous blood transfusion on postoperative complications and outcome of patients with traumatic brain injury |
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| DOI： |
| 中文关键词: 输血治疗 回收式自体输血 创伤性颅脑损伤 术后并发症 转归 |
| 英文关键词: Transfusion therapy Autologous blood transfusion Traumatic brain injury Postoperative complications Outcome |
| 基金项目:广西南宁科技攻关项目(20123240);广西临床重点专科建设资金资助(桂卫医发〔2016〕2号) |
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| 中文摘要: |
| 目的 探讨术中回收式自体输血与异体输血对创伤性颅脑损伤患者行开颅手术后并发症及转归的影响。方法 回顾性分析我院2012年1月至2016年6月行急诊开颅手术的创伤性颅脑损伤患者199例,男161例，女38例，ASA Ⅰ～Ⅳ级，按是否使用自体输血分为自体血组(n=108)和异体血组(n=91)。均采用限制性输血策略,术中及术后通过回输自体血和／或输注RBC以维持Hb 70～100 g／L。记录手术后并发症和输血不良反应,并根据格拉斯哥预后评分(Glasgow outcome score,GOS)判断患者临床转归情况。结果 自体血组术后并发症发生率明显低于异体血组(33% vs. 56%，P<0.01)，输血不良反应发生率明显低于异体血组(5% vs. 14%，P<0.05)，GOS=4分的比例明显高于异体血组(P<0.01)。Logistic回归分析显示异体输血是术后并发症的独立危险因素(OR=1.953，95%CI 1.381~2.529)。结论 自体输血能减少创伤性颅脑损伤患者手术后并发症发生率,降低输血风险,改善患者的临床转归。 |
| 英文摘要: |
| Objective To investigate the effects of autologous blood transfusion and allogeneic blood transfusion on postoperative complications and outcome of patients underwent craniotomy with traumatic brain injury. Methods All transfusional cases underwent emergency craniotomy with traumatic brain injury from January, 2012 to June, 2016, 161 males and 38 females, ASA physical status Ⅰ-Ⅳ, were respectively analyzed and divided into autologous blood group (n=108) and allogeneic blood group (n=91) based on whether or not using cell salvage. The restrictive transfusion strategy was applied in the two groups and the red blood cells were infused to maintain the hemoglobin concentration at 70-100 g／L. The incidence of postoperative complications and adverse transfusion reaction were analyzed and the clinical outcome was judged by Glasgow outcome score (GOS). Results The incidence of postoperative complications (33％ vs. 56％, P＜0.01) and adverse transfusion reaction (5％ vs. 14％, P＜0.05) of the autologous blood group were lower than that in the allogeneic blood group, and the clinical outcome was better (P＜0.01). Logistic regression analysis showed that allogenetic transfusion (OR=1.953, 95％CI 1.381-2.529) was an independent risk factor of postoperative complications. ConclusionThe use of autologous blood transfusion in patients with traumatic brain injury can reduce the incidence of postoperative complications and the risk of blood transfusion and improve clinical outcome. |
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