Tedesco M, Sapienza P, Burchi C, Battistini M, Gramolini R, di Marzo L, Cavallaro A
I Istituto di Clinica Chirurgica, Università degli Studi di Roma La Sapienza.
Ann Ital Chir. 1996 May-Jun;67(3):399-403.
We evaluated the efficiency and costs-effectiveness of blood predonation and intraoperative salvage in elective abdominal aortic aneurysm surgery. Between January 1992 and January 1994, 66 patients (59 male and 7 female, aged 69.9 +/- 0.8 years) who underwent elective surgical repair of an AAA were selected for the study. Thirty-six (54.5%) patients (Group 1) intra- and/or postoperatively received homologous blood whereas 30 (45.5%) patients (Group 2) received autologous blood predonation and intraoperative blood aspiration and reinfusion. The two groups were similar for demographic data, aneurysmal diameter and associated diseases and/or risk factors (p = NS). Operative mortality was comparable between the two groups (p = NS). The mean intraoperative blood loss was 803.4 +/- 104.5 ml in group 1 and 812.8 +/- 44.8 ml in group 2 (p = NS). Group 2 patients received intra- or postoperatively a mean of 0.8 +/- 0.2 units of homologous blood (p < 0.001). Aneurysmal diameter did not influence the transfusion requirement between the two groups (p = NS). The cost per unit of homologous banked blood was significantly higher (p < 0.01). Cumulative costs of the procedures did not show statistical differences between the two groups (p = NS). Aortic surgery is the ideal target for predonation and intraoperative blood salvage.
我们评估了择期腹主动脉瘤手术中自体输血和术中血液回收的效率及成本效益。在1992年1月至1994年1月期间，选取了66例行择期腹主动脉瘤手术修复的患者（59例男性，7例女性，年龄69.9±0.8岁）进行研究。36例（54.5%）患者（第1组）在术中及/或术后接受了异体输血，而30例（45.5%）患者（第2组）接受了自体输血及术中血液抽吸和回输。两组在人口统计学数据、动脉瘤直径及相关疾病和/或危险因素方面相似（p=无显著性差异）。两组的手术死亡率相当（p=无显著性差异）。第1组术中平均失血量为803.4±104.5 ml，第2组为812.8±44.8 ml（p=无显著性差异）。第2组患者在术中或术后平均接受了0.8±0.2单位的异体血（p<0.001）。动脉瘤直径对两组的输血需求无影响（p=无显著性差异）。异体库血的单位成本显著更高（p<0.01）。两组手术的累计成本无统计学差异（p=无显著性差异）。主动脉手术是自体输血和术中血液回收的理想目标。
