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[1]于文娟何欣王岩潘纪春陈麟凤.预存式自体输血在3 038例择期手术患者中的应用研究[J].中国卫生质量管理,2025,32(07):80-83.[doi:10.13912/j.cnki.chqm.2025.32.7.17]
　YU Wenjuan,HE Xin,WANG Yan.A Study on the Application of Preoperative Autologous Blood Donation in 3 038 Patients Undergoing Elective Surgery[J].Chinese Health Quality Management,2025,32(07):80-83.[doi:10.13912/j.cnki.chqm.2025.32.7.17]

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预存式自体输血在3 038例择期手术患者中的应用研究

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 32 期数: 2025年07期页码: 80-83 栏目: 血液质量出版日期: 2025-07-15

Title:: A Study on the Application of Preoperative Autologous Blood Donation in 3 038 Patients Undergoing Elective Surgery

作者:: 于文娟何欣王岩潘纪春陈麟凤; 首都医科大学附属北京世纪坛医院

Author(s):: YU Wenjuan; HE Xin; WANG Yan; Beijing Shijitan Hospital, Capital Medical University

关键词:: 预存式自体输血; 择期手术患者; 回输率; 弃输率; 血液质量; 血液安全

Keywords:: Preoperative Autologous Blood Donation; Elective Surgery Patients; Reinfusion Rate; Discard Rate; Blood Quality; Blood Safety

分类号:: R197.323；R331.1

DOI:: 10.13912/j.cnki.chqm.2025.32.7.17

文献标志码:: A

摘要:: 目的分析预存式自体输血（PABD）在临床择期手术患者中的应用现状，进一步明确PABD适应证，为避免血液资源浪费提供参考。方法收集2018年1月-2023年12月在某院行择期手术的3 038例患者PABD相关资料，探讨PABD在临床科室的分布、回输率及弃输率，并分析其与术中出血量及术前血红蛋白（Hb）水平的相关性。结果2018年到2023年医院PABD回输率呈增长趋势，且弃输率明显降低（P<0.05）。开展PABD较多的科室为淋巴外科、妇科、骨科、胸外科、胃肠外科及腹膜肿瘤外科；产科、胸外科及骨科等科室PABD弃输率较高。出血量＜600 mL组患者PABD弃输率明显高于600 mL～1 000 mL及＞1 000 mL组（P＜0.05）；术前Hb≥150 g/L组患者PABD弃输率明显高于其他各组 (P＜0.05)。出血量＜600 mL、年龄＜40岁、Hb含量≥150 g/L均可造成PABD弃输率增高(P＜0.05)。结论PABD值得推广应用。对于符合PABD采集标准且术中出血量多或Hb水平较低的患者，建议术前进行PABD采集；而术中出血量＜600 mL（特别是年龄＜40岁及Hb≥150 g/L）患者及术前Hb≥150 g/L患者，不建议术前采集贮存式自体血。

Abstract:: ObjectiveTo analyze the current application status of preoperative autologous blood donation (PABD) in patients undergoing elective surgery, further clarify the indications for PABD, and provide references for avoiding the waste of blood resources. MethodsRelevant data on PABD were collected from 3 038 patients who underwent elective surgery in a certain hospital from January 2018 to December 2023. The distribution of PABD across clinical departments, the reinfusion rate, and the discard rate were explored. Additionally, the correlations between PABD and intraoperative blood loss as well as preoperative hemoglobin (Hb) levels were analyzed.ResultsFrom 2018 to 2023, the reinfusion rate of PABD in the hospital showed an increasing trend, while the discard rate significantly decreased (P<0.05). Departments with a higher frequency of PABD implementation included lymphatic surgery, gynecology, orthopedics, thoracic surgery, gastrointestinal surgery, and peritoneal tumor surgery. The discard rates of PABD were relatively high in departments such as obstetrics, thoracic surgery, and orthopedics. The discard rate of PABD was significantly higher in patients with blood loss <600 mL compared to those with blood loss of 600 to 1 000 mL and >1 000 mL (P<0.05). Similarly, the discard rate was significantly higher in patients with preoperative Hb ≥150 g/L compared to other groups (P<0.05). Factors such as intraoperative blood loss <600 mL, age <40 years, and Hb content ≥150 g/L all contributed to an increased discard rate of PABD (P<0.05).Conclusion PABD is worthy of promotion and application. For patients who meet the collection criteria for PABD and have a high expected intraoperative blood loss or low preoperative Hb levels, it is recommended to perform PABD collection preoperatively. However, for patients with intraoperative blood loss <600 mL (especially those aged <40 years and with Hb ≥150 g/L) and those with preoperative Hb ≥150 g/L, preoperative autologous blood collection and storage are not recommended.

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更新日期/Last Update: 2025-07-15