Okita Y, Miki S, Ueda Y, Tabata T, Sakai T, Matsuyama K
Department of Cardiovascular Surgery, Tenri Hospital, Nara, Japan.
J Heart Valve Dis. 1994 Jul;3(4):411-6.
From April 1979 to October 1993, 126 adult patients underwent reoperative cardiac valve surgery. Patients were divided into two groups: 53 patients who underwent surgery before January 1990 (group 1) and 73 patients who underwent surgery after January 1990 (group 2). After January 1990, a clinical strategy for reducing homologous blood transfusions was implemented, including the use of predonation of autologous blood in the operating room, reduced heparin doses, an elevated threshold of indication for blood transfusion, and autotransfusion of shed, drained blood after surgery. In group 1, 44 patients (93.0%) received an average of 3785 +/- 1251 ml of homologous blood transfusions. In group 2, only 26 patients (35.6%) needed homologous blood transfusions and had a smaller amount (2985 +/- 1521 ml) on average. Furthermore, only seven patients needed fresh blood transfusion in group 2.
1979年4月至1993年10月，126例成年患者接受了再次心脏瓣膜手术。患者分为两组：1990年1月前接受手术的53例患者（第1组）和1990年1月后接受手术的73例患者（第2组）。1990年1月后，实施了一项减少同种异体输血的临床策略，包括在手术室使用自体血预存、减少肝素剂量、提高输血指征阈值以及术后对引流血进行自体输血。在第1组中，44例患者（93.0%）平均接受了3785±1251毫升的同种异体输血。在第2组中，只有26例患者（35.6%）需要同种异体输血，平均输血量较少（2985±1521毫升）。此外，第2组中只有7例患者需要输注新鲜血液。
