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腹腔镜手术中常规术前血型鉴定与储血的回顾性研究:一项利用极少的支出

A Retrospective Study of Routine Preoperative Blood Grouping and Saving in Laparoscopic Surgeries: A Minimally Utilized Expenditure.

作者信息

Ramasamy Sadhasivam, Bylapudi Seshu Kumar, Kumar Sidharth, Singh Jatinder, Harvitkar Rafique Umer, Gattupalli Giri Babu, Tanveer Yousaf, Harvitkar Sara, Mohmoud Moustafa, Sayyad Mohamadali

机构信息

General Surgery, Queens Hospital Burton, Burton, GBR.

General Surgery, Kettering General Hospital, Kettering, GBR.

出版信息

Cureus. 2024 Sep 3;16(9):e68557. doi: 10.7759/cureus.68557. eCollection 2024 Sep.

Abstract

Introduction Patients scheduled for laparoscopic cholecystectomy and laparoscopic appendicectomy typically undergo routine preoperative blood grouping and saving (G&S). Despite the low incidence of blood transfusion in this context, the acquisition and processing of G&S samples incur a cost of £31 ($40) per sample. This study aims to review blood transfusion usage in these procedures to determine whether routine G&S sampling is clinically necessary or represents an avoidable expense. Methods A retrospective case note analysis was conducted on patients who underwent laparoscopic cholecystectomy and laparoscopic appendicectomy from January 2019 to June 2020. Collected data included the timing of G&S, preoperative and postoperative hemoglobin levels, timing of blood transfusions, and the number of units transfused. Results Six hundred and thirteen patients were involved in the study. Among the 323 patients who had laparoscopic cholecystectomy, 256 (78.8%) underwent preoperative G&S sampling. Of the 290 patients who had laparoscopic appendicectomy, 190 (65.5%) received preoperative G&S sampling. Notably, none of the 613 patients required a blood transfusion within 30 days of their surgery. The total cost of G&S for the cohort amounted to £22,196 ($28,425). Conclusions The findings suggest that routine G&S sampling is an unnecessary expenditure for patients undergoing elective laparoscopic appendicectomy or cholecystectomy. It is recommended that G&S sampling be reserved for high-risk groups to optimize resource allocation and reduce unnecessary costs.

摘要

引言 计划接受腹腔镜胆囊切除术和腹腔镜阑尾切除术的患者通常会进行术前常规血型鉴定和血液保存(G&S)。尽管在此情况下输血发生率较低,但采集和处理G&S样本每个样本的成本为31英镑(40美元)。本研究旨在回顾这些手术中的输血使用情况,以确定常规G&S采样在临床上是否必要,或者是否属于可避免的费用。方法 对2019年1月至2020年6月期间接受腹腔镜胆囊切除术和腹腔镜阑尾切除术的患者进行回顾性病例记录分析。收集的数据包括G&S的时间、术前和术后血红蛋白水平、输血时间以及输血量。结果 613名患者参与了该研究。在323例行腹腔镜胆囊切除术的患者中,256例(78.8%)进行了术前G&S采样。在290例行腹腔镜阑尾切除术的患者中,190例(65.5%)接受了术前G&S采样。值得注意的是,613例患者中无一例在术后30天内需要输血。该队列的G&S总费用为22,196英镑(28,425美元)。结论 研究结果表明,对于接受择期腹腔镜阑尾切除术或胆囊切除术的患者,常规G&S采样是不必要的支出。建议将G&S采样保留给高危人群,以优化资源分配并降低不必要的成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aade/11449458/71578d366e4d/cureus-0016-00000068557-i01.jpg

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