严重感染患者输血与否的血红蛋白浓度参考标准研究.docVIP

严重感染患者输血与否的血红蛋白浓度参考标准研究 　　[摘要] 目的 探讨严重感染患者输血与否的血红蛋白浓度参考标准。 方法 回顾性分析2010年4月～2015年6月重庆市綦江区人民医院收治的严重感染贫血患者984例的临床资料。根据输血采用的不同的血红蛋白浓度标准将患者分为限制性输血组558例和开放性输血组426例。限制性输血组在血红蛋白浓度 0.05）。两组患者住院期间SOFA各系统评分及总分比较，差异无统计学意义（P 0.05）。两组30 d病死率、心力衰竭发生率比较差异均无统计学意义（P 0.05），但限制性输血组住院期间病死率（36.38%）显著低于开放性输血组（40.14%），差异有统计学意义（P 0.05）。 结论 严重感染患者在血红蛋白浓度70 g/L时输注红细胞，并使其维持在70～90 g/L，有利于减少不必要的输血，且能满足机体代谢的需要，并改善预后。 　　[关键词] 严重感染；输血；血红蛋白；参考标准 　　[中图分类号] R457.1 [文献标识码] A [文章编号] 1673-7210（2016）03（b）-0136-04 　　[Abstract] Objective To explore the reference standard of hemoglobin concentration for blood transfusion or not in patients with serious infection. Methods The clinical data of 94 patients with serious infection admitted to Qijiang Peoples Hospital of Chongqing City from April 2010 to June 2015 was analyzed retrospectively. According to de the difference of reference standard of hemoglobin concentration taken by blood transfusion， the patients were divided into 558 cases of limited blood transfusion group and 426 cases of open blood transfusion group. The limited blood transfusion group was given transfusion of red blood cells 1 U when hemoglobin concentration was lower than 70 g/L， and made it keep on 70-90 g/L； the open blood transfusion group was given transfusion of red blood cells 1 U when hemoglobin concentration was lower than 100 g/L， and made it keep on 100-120 g/L. The blood transfusion conditions were observed， the changes of oxygen dynamics and supersession indexes were analyzed， such as oxygen delivery （DO2）， oxygen consumption （VO2）， oxygen extraction ratio （O2ER）， central venous oxygen saturation （ScvO2）. Sequential organ failure assessment （SOFA） was used to evaluate the conditions of organ failure. The influence of different transfusion programs of the two groups was recorded. Results The amount of transfused red blood cells of limited blood transfusion group [（3.85±1.41） U] was lower than that of open blood transfusion group [（6.95±2.97） U]， the difference was stati