Lowe Emily, Quarmby John
Department of Vascular Surgery, Royal Derby Hospital, Derby, UK.
SAGE Open Med. 2017 Jan 13;5:2050312116688843. doi: 10.1177/2050312116688843. eCollection 2017.
This study aims to identify current blood transfusion requirements in elective open abdominal aortic aneurysm repair and to compare this to an existing maximum surgical blood order schedule.
We retrospectively identified patients who underwent elective open abdominal aortic aneurysm repair over a 40-month period in our institution. Pre-operative number of units cross-matched and the number of units actually transfused were identified. The cross-match to transfusion ratio was then calculated.
Blood transfusion at any time post-operatively was required in 23 (48.9%) cases. Patients needing an intra-operative blood transfusion had a median of 2 units. Of the pre-operative cross-matched units (123), only 43 were used, giving a cross-match to transfusion ratio of 2.86.
Our current maximum surgical blood order schedule is poorly followed and a cross-match to transfusion ratio of 2.86 indicates we are cross-matching too many units for elective open abdominal aortic aneurysm repair. A carefully considered individualised management of blood products, with the requirement of at least a valid group and save sample, may be more appropriate.
本研究旨在确定择期开放性腹主动脉瘤修复术当前的输血需求，并将其与现有的最大手术用血预订计划进行比较。
我们回顾性地确定了在我们机构40个月期间接受择期开放性腹主动脉瘤修复术的患者。确定术前交叉配血的单位数和实际输注的单位数。然后计算交叉配血与输血的比例。
23例（48.9%）患者术后任何时间都需要输血。术中需要输血的患者中位数为2单位。在术前交叉配血的单位（123单位）中，仅使用了43单位，交叉配血与输血的比例为2.86。
我们目前的最大手术用血预订计划执行情况不佳，2.86的交叉配血与输血比例表明，对于择期开放性腹主动脉瘤修复术，我们交叉配血的单位过多。对血液制品进行精心考虑的个体化管理，至少需要一份有效的血型鉴定和保存样本，可能更为合适。
