骨科患者输血与医院感染

目的 探讨输血对骨科患者医院感染发生的影响.方法 采用回顾性试验方法,收集患者的基本资料,记录患者的输血量、输入血的性质及患者医院感染发生情况,选择2008年1-12月医院收治的骨科手术患者517例,其中未输血组251例,输异体血187例,输自体血79例；对3组患者的医院感染发生率进行比较.结果 未输血组患者医院感染率为2.39％,输异体血组医院感染率为9.63％,输自体血患者医院感染率为3.80％,不同输血方式组患者的医院感染率不全相同,差异有统计学意义(P＜0.05)；对其进行两两比较后发现,输异体血组医院感染率高于其他两组,未输血组患者医院感染率与输自体血患者医院感染率差异无统计学意义；输异体血量各组之间与医院感染发生率差异有统计学意义(P＜0.05),输自体血量各组之间与医院感染发生率差异无统计学意义.结论 输自体血患者与输异体血患者医院感染发生与输血成分及输血量等有关；在保证患者循环稳定的情况下,应尽量减少输血,对确需输血的患者,应该在条件允许的情况下输注自体血.

Impact of blood transfusion on nosocomial infection in patients in orthopedics department

OBJECTIVE To investigate the effect of blood transfusion on nosocomial infection rate in orthopedic Hospital,and to provide evidence for reasonable blood transfusion. METHODS Retrospective,controlled study of transfusion practices in 517 patients admitted to the orthopedic hospital from Jan.2008 to Dec.2008 was performed.Patients were divided into three groups,the no blood transfusion group(n=251),the autologous blood transfusion group(n=79) and allogeneic blood transfusion group(n=187).The rates of nosocomial infection of three groups and its correlation to the amount of transfusion were compared. RESULTS The rate of nosocomial infection of the autologous blood transfusion group was 3.80%,of the no blood transfusion group was 2.39%,of the allogeneic blood transfusion group was 9.63%,significantly different from the other two groups.The rate of nosocomial infection was closely correlated to the volume of transfusion in the allogeneic blood transfusion group,but not correlated to the volume of transfusion in the autologous blood transfusion group(P<0.05). CONCLUSION In orthopedic patients,the rate of nosocomial infection is correlated to blood transfusion,blood composition and the volume of transfusion.The blood should not be transfused or transfused as little as possible if the patients are stable.If the blood must be transfused,autologous blood shall be used.