子宫肌瘤剔除术中隐性失血及其影响因素分析。
Analysis of hidden blood loss and its influential factors in myomectomy.
机构信息
Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
出版信息
J Int Med Res. 2020 May;48(5):300060520920417. doi: 10.1177/0300060520920417.
OBJECTIVE
This study was performed to quantify hidden blood loss (HBL) and explore its influential factors in myomectomy.
METHODS
Two hundred nine patients who underwent myomectomy by laparotomy or laparoscopy from 1 January 2017 to 31 December 2018 were analyzed. Each patient's estimated blood volume and total blood loss (TBL) were calculated by the Nadler formula and Gross formula, respectively. The HBL was calculated by subtracting the visible blood loss (VBL) from the TBL. A multivariate linear stepwise analysis was applied to identify the influential factors of HBL in myomectomy.
RESULTS
The mean perioperative VBL and estimated TBL during myomectomy were 137.81 ±104.43 and 492.24 ± 225.00 mL, respectively. The mean HBL was 354.39 ± 177.69 mL, which accounted for 71.52% ± 15.75% of the TBL and was two to three times higher than the VBL. The duration of surgery, number of removed leiomyomas, and location of removed leiomyomas were independent risk factors for HBL in myomectomy.
CONCLUSIONS
HBL accounted for a significant percentage of TBL in myomectomy. A full understanding of the HBL in perioperative blood management may improve patients' postoperative rehabilitation.
目的
本研究旨在量化子宫肌瘤剔除术中的隐性失血（HBL）并探讨其影响因素。
方法
分析了 2017 年 1 月 1 日至 2018 年 12 月 31 日期间接受剖腹手术或腹腔镜手术的 209 例子宫肌瘤剔除术患者。每位患者的估计血容量和总失血量（TBL）分别通过 Nadler 公式和 Gross 公式计算。HBL 通过从 TBL 中减去可见失血量（VBL）来计算。采用多元线性逐步分析来确定子宫肌瘤剔除术中 HBL 的影响因素。
结果
子宫肌瘤剔除术围手术期 VBL 和估计 TBL 平均值分别为 137.81±104.43 和 492.24±225.00 mL。HBL 的平均值为 354.39±177.69 mL，占 TBL 的 71.52%±15.75%，是 VBL 的两到三倍。手术时间、切除肌瘤数量和切除肌瘤位置是子宫肌瘤剔除术 HBL 的独立危险因素。
结论
HBL 占子宫肌瘤剔除术 TBL 的很大比例。充分了解围手术期血液管理中的 HBL 可能会改善患者术后康复。
Zotero 插件