Juma T, Baraka A, Abu-Lisan M, Asfar S K
Department of Surgery Amiri Teaching Hospitals, Kuwait.
J R Soc Med. 1990 Jun;83(6):368-70. doi: 10.1177/014107689008300610.
A prospective study was carried out for 6 months to determine the efficacy of blood ordering routines for elective surgery. It was found that only 23% of procedures needed preoperative crossmatching of blood (transfusion index 'TI' greater than 0.5). There was an excessive over-ordering of blood for 77% of the operations (crossmatch/transfusion ratio greater than 2.5). In addition, the transfusion index for the latter group showed that there was no need to prepare blood preoperatively (TI less than 0.5). A transfusion tariff is worked out which abandons crossmatching for the majority of procedures (cholecystectomy, thyroidectomy and surgery for duodenal ulcer excluding gastrectomy). Instead a 'group and screen' policy is suggested.
进行了一项为期6个月的前瞻性研究,以确定择期手术用血预订程序的有效性。结果发现,只有23%的手术需要术前交叉配血(输血指数“TI”大于0.5)。77%的手术存在过度用血预订情况(交叉配血/输血比大于2.5)。此外,后一组的输血指数表明术前无需备血(TI小于0.5)。制定了一项输血收费标准,该标准放弃了大多数手术(胆囊切除术、甲状腺切除术以及十二指肠溃疡手术,但不包括胃切除术)的交叉配血。相反,建议采用“血型鉴定和筛查”策略。