Nash P A, Schrepferman C G, Rowland R G, Young J, Foster R S, Birhle R, Donohue J P
Department of Urology, Indiana University Medical Center, Indianapolis, USA.
Br J Urol. 1996 Jun;77(6):856-60.
To assess the impact of pre-donated autologous blood and intra-operative isovolaemic haemodilution on the outcome of transfusions in patients undergoing radical retropubic prostatectomy.
The charts and transfusion records of 192 consecutive patients undergoing radical retropubic prostatectomy were reviewed retrospectively.
Of 192 patients, 14% required homologous transfusions, the rate of which varied significantly depending upon blood availability (autologous, haemodilution or homologous) (P < 0.001): 66% of patients with only autologous blood available were transfused a mean of 1.96 units (range 1-6) of blood, of which 87% received autologous alone. 12% both autologous and homologous and 1% homologous blood only. Of the pre-donated autologous units, 44% were wasted.
Both the pre-donation of autologous blood and intra-operative isovolaemic haemodilution lower the risk of homologous blood transfusion. It is recommended that patients pre-donate 2 units of autologous blood and undergo intra-operative isovolaemic haemodilution before radical prostatectomy.
评估术前预存自体血和术中等容血液稀释对耻骨后根治性前列腺切除术患者输血结局的影响。
回顾性分析192例连续接受耻骨后根治性前列腺切除术患者的病历及输血记录。
192例患者中，14%需要异体输血，异体输血率因血液供应情况（自体血、血液稀释或异体血）不同而有显著差异（P<0.001）：仅有自体血可用的患者中，66%平均输注1.96单位（范围1 - 6单位）血液，其中87%仅接受自体血输注，12%接受自体血和异体血输注，1%仅接受异体血输注。术前预存的自体血单位中，44%被浪费。
术前预存自体血和术中等容血液稀释均可降低异体输血风险。建议患者在根治性前列腺切除术前行2单位自体血预存并进行术中等容血液稀释。
