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目的联合国内20家大型综合医院多中心回顾性调研外科住院患者大量输血病例1601例,分析探讨不同科室输血情况与患者死亡率的关联性。方法联合全国20家三级综合医院进行多中心回顾性分析不同科室输血情况,根据24h内不同科室用血情况分为:创伤科、心外科、外科、产科,大量输血四类不同科别患者住院期间死亡时间有一定差异,总体合计后死亡率有一定差异。结果 24h内输注红细胞≥10U时,四类科室患者的死亡率顺序为:心脏外科(18.4%)>创伤科室(14.4%)>产科(5.7%)>普通外科(5.4%);24h内输注红细胞<10U时,死亡率顺序为:创伤科室(8.6%)>普通外科(3.9%)>心脏外科(3.4%)>产科。结论不同科室的病种特征不同,其基线数据如输血前患者的性别、年龄、体重、手术时间、血常规及血凝指标等均具有明显差异,我们在制定大量输血方案时,尽可能对心脏外科和创伤患者制定相对独立的输血方案,更进一步减少死亡率。
Objective To retrospectively investigate 1601 cases of massive transfusion of surgical inpatients in 20 large general hospitals in United Nations, and to analyze the correlation between the blood transfusion status and patient mortality in different departments. METHODS: A total of 20 tertiary hospitals in China were retrospectively analyzed retrospectively on the transfusion status in different departments. According to the blood usage in different departments within 24 hours, the patients were divided into four groups: traumatology, cardiology, surgery, obstetrics and mass transfusion. During the period of death there are some differences, the overall total mortality after a certain difference. Results The sequence of death in four departments was as follows: cardiac surgery (18.4%), trauma department (14.4%) obstetrics (5.7%) general surgery (5.4%), The order of mortality was 10% for erythrocytes, trauma department (8.6%), general surgery (3.9%), cardiac surgery (3.4%) obstetrics. Conclusions The characteristics of different kinds of diseases are different in different departments. The baseline data such as the gender, age, weight, operation time, blood and blood coagulation index before transfusion are significantly different. When we develop a large number of transfusion regimens, Surgical and traumatic patients to develop a relatively independent transfusion program to further reduce mortality.