烧伤切削痂手术时失血量的估计和围手术期输血

目的探讨烧伤切削痂手术时失血量的肉眼估计值和计算值的实用价值,并就围手术期输血提出对策建议。方法对32例早期切削痂手术失血量的肉眼估计值、按公式计算值、实际输血量及手术前后Hb变化进行观察比较。结果切削痂手术失血量的肉眼估计值为(59.64±23.56)ml/1%切削痂,失血量的计算值为(100.45±52.04)ml/1%切削痂,实际输血量为(73.75±51.73)ml/1%切削痂,手术后Hb平均下降约15g/L。结论失血量的肉眼估计值尽管偏低,但相当可靠;失血量的计算值更接近于实际的失血量。两者可作为实际应用时的参考。

The estimation of blood 1oss during burn excision surgery and the strategy of blood transfusion in perioperative stage

Objective To determine the reliability of the value of calculated blood loss and the value of the eye estimate of blood loss during burn surgery.Methods Thirty-two patients were involved in this prospective clinical study.The value of calculated blood loss,the value of eye estimate of blood loss,ac-tualy blood transfusion volume ,and Hb changes before and after burn excision operation were observed and compared.Results The mean value of blood loss for1per cent of burn excised or split skin donor site harvested by the eye estimate was(59.64±23.56)ml /1%,comparing with the value of(100.45±52.04)ml/1%by calculation.Statistical analysis showed good correlation between these methods(r=0.42).Conclusion Calculated blood loss seems to more approximate to the actual blood loss.The volume of blood transfusion in this group was(73.75±51.73)ml ,slightly higher than the eye estimate but significant-ly lower than the calculation,resulted in15g /L Hb level reduced postoperatively on an average.The strategy of blood transfusion in perieoperative stage would be based on the above results.