中国不同区域20家三级综合医院外科大量输血后血常规及凝血检测频率与病死率的关联性分析

目的 了解外科大量输血时血细胞检测与凝血指标检测频率与病死率的相关性。方法 对中国不同区域20家三级综合医院1 682例输血患者进行多中心回顾性分析,采用统一调研表格,统计分析红细胞悬液输注量<10 U及≥10 U情况下血细胞检测及凝血检测频次与病死率。结果 ①不同输血量时(<10 U组,≥10 U组)血细胞检测及凝血检测频率差异均有统计学意义(P<0.05)。②外科不同病类红细胞悬液输注量≥10 U血细胞检测及凝血检测1次以上与没有检测者差异均有统计学意义(Q_smh=8.286 7,P=0.004 0; Q_smh=20.383 9,P<0.000 1)。③外科大量输血患者血细胞检测及凝血指标检测频次与病死率均呈负相关(r=-0.900,P=0.037; r=-0.975,P=0.005)。结论 外科大量输血时血细胞检测及凝血指标检测的及时性对降低患者死亡率具有一定的意义。

Relevance between Frequency of the Blood Indicator Detection and the Case Fatality Rate in Massive Transfusion Surgical Patients

Objective The observational study was conductedto define relevance between frequency of the hemocytography and the case fatality rate in massive transfusion surgical patients.Methods The frequency of the hemocytography and the case fatality rate were analyzed by multicenter retrospective study in 1 682 transfused patients from 20 tertiarycomprehensive hospitals in different regions in China.The patients were transfused RBC with different volume in two groups which one was greater than or equalto 10 U,the other was lesser than 10 U.Results ①Therewere significant differences in different amount of transfusion(<10 U group,≥10 U group)in the frequency of routine blood test and the coagulation tests(P<0.05).②Obvious difference of routine blood test was seen between the frequency was 0 and the frequency was equal greater than 1 in massive transfusionsurgical patients,so did the coagulation tests(Q_smh=8.286 7,P=0.0040; Q_smh=20.383 9,P<0.000 1).③The results showed a negative relation between frequency of the routine blood test and the case fatality rate,so did the coagulation tests(r=-0.900,P=0.037; r=-0.975,P=0.005).Conclusion It is significant to the timeliness of hemocytography in massive transfusion surgical patients to reduce the case fatality rate.