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手术患者无创血红蛋白测量指导下的靶向出血管理

Targeted Bleeding Management Guided by Non-Invasive Haemoglobin Measurement in Surgical Patients.

作者信息

Akdag Sukriye, Zengin Seniyye Ulgen, Cakmak Gul, Umuroglu Tumay, Aykac Zeynep Zuhal, Saracoglu Ayten

机构信息

Department of Anaesthesiology and Reanimation, Marmara University, Istanbul, Turkey.

出版信息

J Coll Physicians Surg Pak. 2022 Oct;32(10):1242-1248. doi: 10.29271/jcpsp.2022.10.1242.

Abstract

OBJECTIVE

To assess blood transfusion decisions in blood losses using a continuous total haemoglobin (SpHb) and non-invasive haemoglobin (Hb) device.

STUDY DESIGN

Double-blinded randomised controlled trial.

PLACE AND DURATION OF STUDY

Marmara University Hospital, Istanbul, Turkey, from March 2018 to December 2019.

METHODOLOGY

One hundred and twenty adult patients scheduled for elective major surgery and expected to experience a blood loss greater than 20% of their total blood volume were divided into two groups. These groups were compared for bleeding management with conventional blood gas sampling (Group Hb, the control group) according to Hb monitoring versus SpHb measurement (Group SpHb, the study group).

RESULTS

In the postoperative measurement, there were fewer red blood cells (RBC) in the SpHb group than in the Hb group (p=0.020). There was a greater change in the amount of RBC from the perioperative to the postoperative period in the SpHb group compared to the Hb group (p<0.001). Postoperative Hb levels of patients in the intensive care unit (ICU) were higher in the SpHb group than in the Hb group (p<0.05).

CONCLUSION

SpHb can provide effective patient blood management in cases of major surgery. It does not cause a delay in the decision of blood transfusion during surgery.

KEY WORDS

Haemorrhage, Anaemia, Blood transfusion, General surgery.

摘要

目的

使用连续总血红蛋白(SpHb)和无创血红蛋白(Hb)设备评估失血情况下的输血决策。

研究设计

双盲随机对照试验。

研究地点和时间

2018年3月至2019年12月,土耳其伊斯坦布尔马尔马拉大学医院。

方法

120例计划接受择期大手术且预计失血量超过其总血容量20%的成年患者被分为两组。根据Hb监测与SpHb测量,将这两组与采用传统血气采样的出血管理组(Hb组,对照组)进行比较(SpHb组,研究组)。

结果

术后测量中,SpHb组的红细胞(RBC)数量少于Hb组(p = 0.020)。与Hb组相比,SpHb组从围手术期到术后期间RBC数量的变化更大(p < 0.001)。SpHb组重症监护病房(ICU)患者的术后Hb水平高于Hb组(p < 0.05)。

结论

SpHb可在大手术病例中提供有效的患者血液管理。它不会导致手术期间输血决策的延迟。

关键词

出血、贫血、输血、普通外科。

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