Jecker P, Melzer A, Hitzler W E
Hals-Nasen-Ohrenklinik, Johannes-Gutenberg-Universität, Mainz.
HNO. 2005 Nov;53(11):945-51. doi: 10.1007/s00106-005-1224-3.
Sometimes, use of blood products is necessary in head and neck surgery, but blood transfusion also entails risks for the patients and causes high costs for the department. Therefore, we examined the surgical procedures in our department and analysed how often transfusion of blood was necessary and which expenses were incurred.
Of 3989 operations performed in 1989, 187 patients were found to be at an increased risk for blood loss. The costs for blood group analysis (euro 23.16), cross-testing (euro 13.91) and the transfusion itself (euro 70.35) were estimated in each patient.
In 1998 more than 60% of the 187 patients had undergone extensive head and neck surgery for advanced squamous cell carcinoma. Only 17 patients (<15%) received nearly 45% of all units of stored blood transfused that year. In patients who had undergone skull base surgery, the probability of receiving blood was 30%. The transfusion-related costs were estimated to be euro 20,000 during the observation period. Potential savings could have been achieved in cross-testing.
Preparations should be done on an individual basis. Such preparations are sometimes unnecessary even in patients undergoing surgical procedures with a high risk for blood loss.
有时，头颈部手术中需要使用血液制品，但输血也给患者带来风险，且会给科室带来高昂成本。因此，我们检查了本科室的手术流程，分析了输血的必要性以及产生的费用情况。
在1989年进行的3989例手术中，发现187例患者失血风险增加。估算了每位患者血型分析（23.16欧元）、交叉配血（13.91欧元）及输血本身（70.35欧元）的费用。
1998年，187例患者中超过60%因晚期鳞状细胞癌接受了广泛的头颈部手术。当年仅17例患者（<15%）接受了近45%的库存输血单位。接受颅底手术的患者输血概率为30%。观察期内输血相关费用估计为20,000欧元。交叉配血方面可能实现潜在节约。
应根据个体情况进行准备。即使在失血风险高的手术患者中，此类准备有时也是不必要的。
