中国输血杂志2023，Vol.36Issue(11)：999-1004,6.DOI:10.13303/j.cjbt.issn.1004-549x.2023.11.006
肝移植患者围术期PBM的建立与实施
Perioperative PBM in liver transplant patients:establish-ment and implementation
摘要
Abstract
Objective To establish a practical and feasible blood management(PBM)model for clinical liver transplant patients,so as to optimize the perioperative blood usage and improve patient prognosis and survival rate.Methods Led by the Medical Department,a questionnaire survey Establishment and Implementation of a Blood Management Model for Organ Transplant Patients on the importance of establishing a PBM model for liver transplant patients in clinical practice was con-ducted among 71 staff from relevant departments such as the Anesthesiology Department,Hepatobiliary Department,Blood Transfusion Department,and ICU Medical Department.After statistical analysis,the important items of PBM for liver trans-plant patients were determined,and a(trial)plan was organized by the Medical Department and training was conducted by Blood Transfusion Department for medical staff training from departments as Anesthesiology,Hepatobiliary and Pancreatolo-gy,and ICU;PBM measures for liver transplant patients before,during and after surgery were determined by the Anesthesi-ology Department,Hepatobiliary and Pancreatic Department,and ICU;PBM was fully implemented in the experimental group with liver transplant patients in our hospital in 2021 as subjects;30 cases of liver transplantation performed in our hos-pital in 2020 were selected as the control group,and the general data,preoperative laboratory examination results,and pre-operative,intraoperative,and postoperative blood transfusion of the two groups of patients were compared.Results Com-pared with the control group,the experimental group did not receive any blood component transfusion before surgery.Intraop-erative blood transfusion volume of allogeneic components:red blood cells(U)were 12.75(8.75,18.63)vs 15.25(8.38,26.13)(P＞0.05),apheresis platelet(treatment volume)was 0(0,2)vs 1(0,4.25)(P＞0.05),plasma(U)was 2 300(1 550,3 763)vs 3 650(2 075,5 400)(P＜0.05);cryoprecipitate(U)was 0(0,10)vs 10(0,30)(P＜0.05);Postoper-ative blood transfusion volume of allogeneic components were as follows:red blood cells(U)8.00(3.38,12.88)vs 11.25(4.75,19.63)(P＞0.05),platelets were not transfused,plasma(U)was 0(0,0)vs 0(0,600)(P＞0.05),and cryoprecipi-tates were not transfused.Conclusion The establishment of PBM model for liver transplant patients and the application of its management measures before,during and after transplantation significantly reduced the intraoperative blood transfusion volume and improved the prognosis of patients after transplantation.关键词
患者血液管理/肝移植术/用血量/围术期输血Key words
patient blood management/liver transplantation/blood usage/perioperative blood transfusion分类
临床医学引用本文复制引用
侯星羽,秦雯,海帆,李兵,普丽,宋松涛,陈刚,徐荣华..肝移植患者围术期PBM的建立与实施[J].中国输血杂志,2023,36(11):999-1004,6.基金项目
云南省器官移植临床医学中心开放课题(ZX2019-07-01/2020SYZ-Z-039) （ZX2019-07-01/2020SYZ-Z-039）
