摘要
目的回顾多中心大面积烧伤患者的输血情况并分析其影响因素。方法采用回顾性病例系列研究方法。收集2016年1月—2022年6月3家医院烧伤中心收治的455例符合入选标准的大面积烧伤患者的临床资料,其中南昌大学第一附属医院202例、浙江大学医学院附属第二医院179例、安徽医科大学第一附属医院74例。统计患者住院期间输注红细胞、血浆及血小板的情况;年龄、性别、体重指数、合并基础疾病情况、致伤原因、伤后入院时间、入院类型、烧伤总面积、Ⅲ度烧伤面积、合并吸入性损伤情况、合并其他创伤情况、合并肺水肿情况;入院24 h内血乳酸、血肌酐、总胆红素、白蛋白值;合并血流、创面、肺部、尿路感染情况,合并脓毒症情况;切削痂植皮手术(以下简称手术)次数、总手术失血量;出现血红蛋白<70 g/L情况、入住重症监护病房(ICU)情况、行机械通气情况、行连续性肾脏替代治疗(CRRT)情况、住院天数及预后。再收集患者在伤后14 d内行602次手术的单次手术切削痂和取皮面积、单次手术时长、单次手术失血量、手术部位、止血带和创面移植物使用情况。对数据行Mann-WhitneyU检验、Kruskal-WallisH检验、Spearman相关分析。结合单因素分析结果及临床意义,进行多元线性回归分析,筛选患者红细胞输注量和血浆输注量以及单次手术失血量的独立影响因素。结果在整个住院期间,有437例(96.0%)患者进行了输血治疗,分别有435例(95.6%)、410例(90.1%)、73例(16.0%)患者输注了血浆、红细胞、血小板。患者以男性为主,年龄18~92岁。不同合并基础疾病情况、合并吸入性损伤情况、合并其他创伤情况、合并肺水肿情况、合并血流感染情况、合并创面感染情况、合并肺部感染情况、合并尿路感染情况、合并脓毒症情况、出现血红蛋白<70 g/L情况、入住ICU情况、行机械通气情况、行
Objective To retrospect the blood transfusion status of patients with extensive burns in multiple centers and analyze its influencing factors.Methods A retrospective case series study was conducted.Clinical data of 455 patients with extensive burns who met the inclusion criteria and were admitted to the burn centers of 3 hospitals from January 2016 to June 2022 were collected,including 202 patients from the First Affiliated Hospital of Nanchang University,179 patients from the Second Affiliated Hospital of Zhejiang University School of Medicine,and 74 patients from the First Affiliated Hospital of Anhui Medical University.The following data were collected from patients during their hospitalization,including infusion of red blood cells,plasma,and platelets during hospitalization;age,gender,body mass index,combined underlying diseases,cause of injury,time of admission after injury,type of admission,total burn area,full-thickness burn area,combination of inhalation injury,combination of other trauma,and combination of pulmonary edema;the blood lactic acid,serum creatinine,total bilirubin,and albumin values within 24 h of admission;combination of bloodstream,wound,lung,and urinary tract infection,and combination of sepsis;the number of escharectomy or tangential excision and skin grafting surgery(hereinafter referred to as surgery)and total surgical blood loss volume;occurrence of hemoglobin<70 g/L,admission to intensive care unit(ICU),conduction of mechanical ventilation and continuous renal replacement therapy(CRRT),length of hospital stay,and prognosis were recorded.In 602 surgeries of patients within 14 days after injury,data including area of escharectomy or tangential excision and skin graft harvesting,duration of operation,and surgical blood loss volume per surgery,operation site,and use of tourniquet and wound graft were collected.Data were statistically analyzed with Mann-Whitney U test,Kruskal-Wallis H test,and Spearman correlation analysis.Combined with the results of single factor analysis and clinical si
作者
段德庆
陈永
邓鸿敖
胡时强
毛远桂
刘德伍
韩春茂
徐庆连
张红艳
Duan Deqing;Chen Yong;Deng Hong'ao;Hu Shiqiang;Mao Yuangui;Liu Dewu;Han Chunmao;Xu Qinglian;Zhang Hongyan(Medical Center of Burn Plastic and Wound Repair,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Burn and Wound Repair,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Burns,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《中华烧伤与创面修复杂志》
CAS
CSCD
北大核心
2023年第11期1047-1056,共10页
Chinese Journal of Burns And Wounds
基金
国家自然科学基金地区科学基金项目(30960401,82360450)
江西省自然科学基金(20181BAB205041)。
关键词
烧伤
输血
失血
手术
影响因素分析
Burns
Blood transfusion
Blood loss,surgical
Root cause analysis
