Wang C, Lau W, Herst R, Drutz H, Fernandes B
Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Transfus Med. 1998 Mar;8(1):23-7. doi: 10.1046/j.1365-3148.1998.00121.x.
Autologous blood transfusion was evaluated in gynaecological repair procedures including abdominal/ vaginal hysterectomy with vaginal repair, post-hysterectomy vaginal suspension and fixation, uni/bilateral salpingo-oophorectomy with vaginal colpopexy and sling procedures. A total of 247 autologous units were collected from 95 patients at the regional blood centre with 1-3 units (mean 2-6 units) deposition from each patient. One hundred and ninety of all collected units were transfused (collection/transfusion ratio = 1.3). Of these patients, 86 (90.5%) received autologous blood; 12 (13%) being transfused with 1 unit, 44 (46%) with 2 units and 30 (32%) with 3 units. Two of these patients received additional homologous blood. The average preoperative haemoglobin level was 119 g L-1 and average post-operative haemoglobin level was 105 gL-1. The post-operative Hb level was used as a retrospective indicator for the requirement for blood transfusion. The results show that overall 75% of patients had post-operative haemoglobin levels < or = 110 and 33% of patients with Hb levels < 100, respectively. These results suggest that preoperative autologous blood deposition may be appropriate in the patients undergoing reconstructive gynaecological repair procedures since there was a high rate of usage of autologous blood and low post-operative haemoglobin in a significant proportion of patients.
在妇科修复手术中对自体输血进行了评估,这些手术包括腹式/阴道子宫切除术加阴道修复、子宫切除术后阴道悬吊和固定术、单侧/双侧输卵管卵巢切除术加阴道阴道固定术以及吊带手术。在区域血库从95名患者中总共采集了247个自体单位,每位患者采集1 - 3个单位(平均2.6个单位)。所有采集的单位中有190个进行了输血(采集/输血比例 = 1.3)。在这些患者中,86名(90.5%)接受了自体血;12名(13%)输注1个单位,44名(46%)输注2个单位,30名(32%)输注3个单位。其中两名患者还接受了异体血。术前平均血红蛋白水平为119 g/L,术后平均血红蛋白水平为105 g/L。术后血红蛋白水平被用作输血需求的回顾性指标。结果显示,总体上75%的患者术后血红蛋白水平≤110,分别有33%的患者血红蛋白水平<100。这些结果表明,对于接受妇科重建修复手术的患者,术前自体血采集可能是合适的,因为自体血使用率高,且相当一部分患者术后血红蛋白水平较低。