Das A, Strup S, Canfield S, Mulholland S G, Gomella L G
Department of Urology, Kimmel Cancer Center, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Tech Urol. 1998 Sep;4(3):131-5.
We investigated the utilization patterns of autologous blood donation for radical retropubic prostatectomy (RRP) during a 6-year period. A total of 225 patients electing RRP with blood donation were identified for analysis. Group 1 consisted of 113 men who had an RRP from 1990 to 1993. Group 2 consisted of 112 men who had an RRP from 1993 to 1995. Charts were reviewed for the number of units transfused, number of autologous units donated, and operative blood loss. More patients autodonated blood in the later group (84% vs. 75%). Technical improvements and experience have significantly decreased blood loss and the need for transfusions (69% vs. 96% in the early group). In the more current series, only 14% of patients who autodonated blood required homologous transfusion vs. 42% in the earlier group. An increase in the amount of wasted blood (42% vs. 16% in the early group) also was noted. The 4-unit donors had the lowest homologous transfusion rate in both series (group 1 = 21%, group 2 = 5%); the 2-unit donors had the lowest units wasted per person (0.74). In addition, the 2-unit donors maintained a low homologous transfusion rate of 16%. These data suggest that 2 units of autologous blood donation has a reduced risk of homologous blood transfusion while the amount of autologous blood wasted is minimized.
我们调查了6年间耻骨后根治性前列腺切除术(RRP)中自体输血的使用模式。共有225例选择RRP并进行输血的患者被纳入分析。第1组由1990年至1993年接受RRP的113名男性组成。第2组由1993年至1995年接受RRP的112名男性组成。查阅病历以获取输血单位数、自体献血单位数和手术失血量。后期组中更多患者进行了自体输血(84%对75%)。技术改进和经验显著减少了失血量和输血需求(早期组为69%对96%)。在最近的系列中,自体输血的患者中只有14%需要异体输血,而早期组为42%。还注意到浪费血量有所增加(早期组为42%对16%)。在两个系列中,捐献4单位血液的患者异体输血率最低(第1组=21%,第2组=5%);捐献2单位血液的患者人均浪费单位数最少(0.74)。此外,捐献2单位血液的患者异体输血率维持在16%的低水平。这些数据表明,捐献2单位自体血可降低异体输血风险,同时将自体血浪费量降至最低。