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临床输血与检验 ›› 2022, Vol. 24 ›› Issue (6): 721-724.DOI: 10.3969/j.issn.1671-2587.2022.06.008

• 临床输血 • 上一篇    下一篇

术前贫血对先天性心脏病患儿围术期输血及预后的影响分析

胡恒雅, 周小玉   

  1. 210029 南京,南京医科大学第一附属医院
  • 收稿日期:2022-05-12 发布日期:2023-01-05
  • 通讯作者: 周小玉,女,硕士,主任技师,主要从事临床输血研究,(E-mail)deerzxy@163.com。
  • 作者简介:胡恒雅(1994-),女,检验师,学士,主要从事临床输血方面研究,(E-mail)294645688@qq.com。

The Effect of Preoperative Anemia on Perioperative Transfusion and Postoperative Outcomes in Children with Congenital Heart Disease

HU Heng-ya, ZHOU Xiao-yu   

  1. Department of Blood Transfusion, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029
  • Received:2022-05-12 Published:2023-01-05

摘要: 目的 探讨先天性心脏病患儿术前贫血与围术期输血的相关性以及对预后转归的影响。方法 应用输血信息管理系统(BLOOD)及SPSS软件对我院2019年4月~2022年4月89例进行首次择期手术的先天性心脏病患儿进行回顾性调查,对其临床资料、相关实验室检查、围术期输血、预后等资料进行回顾性分析,根据患者是否存在术前贫血,分为贫血组(n=22)和非贫血组(n=67)。结合单因素分析和线性回归模型探讨术前贫血对患儿先天性心脏病围术期输血量及术后影响。结果 本组先天性心脏病患儿术前贫血发生率为24%(22/89),两组患儿围术期血浆输注量、术中出血量、尿量、超滤量、体外循环时间、主动脉阻断时间、延迟关胸、并发症发生率差异无统计学意义(P>0.05),但贫血患儿围术期红细胞和冷沉淀输注量更高,机械通气、ICU停留天数及住院天数均延长,差异具有统计学意义(P=0.003、0.017、0.005、0.003、0.005)。结论 术前贫血可增加围术期红细胞和冷沉淀输注量,延长机械通气时间、术后ICU停留时间、住院天数,为患者不良预后的危险因素。

关键词: 术前贫血, 先天性心脏病, 围术期输血, 预后转归

Abstract: Objective To discuss the associations between preoperative anemia, perioperative transfusion, and postoperative outcomes in children with congenital heart disease(CHD). Methods Data recorded for 89 children underwent their first selective operation in our hospital were retrospectively collected from the blood transfusion information management system (BLOOD) and SPSS software. Data included clinical data, relevant lab test results, perioperative transfusion and prognosis and outcomes. Patients were divided into two groups: anemia group (n=22) with a history of preoperative anemia and non-anemia group (n=67) without. Univariate analysis and linear regression model examined the effect of preoperative anemia on the perioperative transfusion and postoperative outcomes in children with congenital heart disease. Results The incidence of preoperative anemia was 24% (22/89). There was no significant difference in intraoperative blood loss, urine volume, ultrafiltration volume, cardiopulmonary bypass time, and aortic occlusion time between the two groups (P>0.05). However, the perioperative RBC transfusion and cryoprecipitate infusion were higher, and mechanical ventilation time, ICU stay and hospital stay were all prolonged in anemia group, with statistically significant difference (P=0.003, 0.017, 0.005, 0.003, 0.005,respectively). Conclusion Preoperative anemia can increase perioperative RBC transfusion and cryoprecipitate transfusion, and prolong mechanical ventilation time, postoperative ICU stay and hospital stay. Those were risk factors of poor prognosis.

Key words: Preoperative anemia, Congenital heart disease, Perioperative transfusion, Prognosis and outcome

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