Søndenaa K, Salte J, Braut H, Ostgaard P
Kirurgisk avdeling, Sentralsjukehuset i Rogaland, Stavanger.
Tidsskr Nor Laegeforen. 1990 Nov 30;110(29):3725-8.
New light has recently been shed on transfusion therapy. Early recurrence of cancer, ill effects on the immune system and increased incidence of postoperative infections have all been suggested as possible complications of overenthusiastic transfusion therapy. The need for perioperative transfusions has been overestimated in the past, since new physiological investigations show that a hemoglobin level of 8 g/100 ml can be tolerated at elective surgery provided that the patient is normovolemic and normothermic. Neither has the danger of virus contamination been entirely eliminated. With this in mind, blood component therapy, giving erythrocytes and plasma components according to documented need, has been started. The article describes our institution's suggested policy for transfusion therapy and volume treatment in elective and trauma surgery.
近期,输血治疗有了新的进展。癌症早期复发、对免疫系统的不良影响以及术后感染发生率增加,都被认为是过度积极的输血治疗可能引发的并发症。过去,围手术期输血的必要性被高估了,因为新的生理学研究表明,在择期手术中,只要患者血容量正常且体温正常,血红蛋白水平为8克/100毫升是可以耐受的。病毒污染的风险也尚未完全消除。考虑到这一点,已开始根据记录的需求给予红细胞和血浆成分的血液成分治疗。本文描述了我们机构针对择期手术和创伤手术中输血治疗及容量治疗的建议策略。