组织工程与重建外科杂志2023，Vol.19Issue(6)：553-557,5.DOI:10.3969/j.issn.1673-0364.2023.06.007
颅颌面畸形矫形术中回收式自体输血患者异体输血合理性研究及大量输血预防性护理效果
Research on reasonableness of allogeneic blood transfusion in patients with autologous blood transfusion and preventive nursing efficacy of massive transfusion in orthopedic surgery for craniofacial deformity
王颖 1王烨 2支延康2
作者信息
- 1. 200011 上海市 上海交通大学医学院附属第九人民医院整复外科
- 2. 200011 上海市 上海交通大学医学院附属第九人民医院麻醉科
- 折叠
摘要
Abstract
Objective To understand the allogeneic red blood cell infusion in patients with autologous blood transfusion and evaluate the reasonableness of allogeneic blood transfusion in orthopedic surgery for craniofacial deformity;To explore the risk factors for unreasonable blood transfusion;To establish a decision-making model for reasonable allogeneic red blood cell infusion in this type of surgery;And to assess the preventive nursing efficacy of massive transfusion.Methods The patients who received extensive operations on craniofacial deformity and autologous blood transfusion were selected as research objects.The theoretical hemoglobin value after the completion of intraoperative salvaged autologous blood transfusion at the end of operations was estimated,and unreasonable blood transfusion was defined as being greater than 100 g/L and receiving allogeneic red blood cell infusion.The differences in various clinical indexes between unreasonable blood transfusion patients and other patients were compared,and the risk factors related to unreasonable blood transfusion were analyzed via the regression model.Artificial intelligence neural network algorithm was used to establish a decision-making model for reasonable allogeneic red blood cell infusion in this type of surgery.The preventive nursing efficacy of massive transfusion was assessed by reviewing adverse reactions in perioperative blood transfusion.Results A total of 63 patients with intraoperative autologous blood transfusion were included in this study, of which the allogeneic red blood cell infusion rate was 96.83％ (61/63) and the unreasonable allogeneic red blood cell infusion rate was 36.07％ (22/61). The regression model did not find relatively independent risk factors that lead to unreasonable allogeneic blood transfusion. The area under the ROC curve in the decision-making model for reasonable allogeneic red blood cell infusion was close to 100％. After using a lot of preventive nursing measures for blood transfusion in this type of surgery, no serious complications related to blood transfusion occurred. Conclusion There are many unreasonable allogeneic red blood cell infusion phenomena in patients with autologous blood transfusion in orthopedic surgery for craniofacial deformity. It's suggested that the model in this study should be used to evaluate the necessity of allogeneic red blood cell infusion at any time according to the changes of blood loss and autologous blood transfusion volume, so as to avoid unreasonable allogeneic blood transfusion. The efficacy of preventive nursing measures for massive transfusion is definite in this type of surgery.关键词
颅颌面畸形/术中回收式自体输血/血液管理Key words
Craniofacial anomalies/Intraoperative autotransfusion/Blood management分类
医药卫生引用本文复制引用
王颖,王烨,支延康..颅颌面畸形矫形术中回收式自体输血患者异体输血合理性研究及大量输血预防性护理效果[J].组织工程与重建外科杂志,2023,19(6):553-557,5.
