目的评价氨甲环酸(TXA)对房间隔缺损(ASD)患儿围术期的血液保护作用及对不良事件发生率和死亡率的近期与长期影响。方法回顾性队列研究:连续选取本院2009年1月—2010年12月接受ASD修补术的单纯ASD患儿224名,根据术中是否应用TXA被分TXA...目的评价氨甲环酸(TXA)对房间隔缺损(ASD)患儿围术期的血液保护作用及对不良事件发生率和死亡率的近期与长期影响。方法回顾性队列研究:连续选取本院2009年1月—2010年12月接受ASD修补术的单纯ASD患儿224名,根据术中是否应用TXA被分TXA组(n=96)和对照组(n=128),年龄2个月—6(3.23±2.22)岁,美国麻醉师协会(ASA)分级为1—2级;在术后第7年电话随访患儿及其家属。记录并统计分析患儿主要的围术期出血和输血及术后近远期不良事件的发生率和死亡率。结果对照组和TXA组ASD患儿出血量(mL):术中59.83±2.11 vs 62.01±2.44(P>0.05),术后99.47±3.86 vs 85.97±4.46(P<0.05);输血量:红细胞(U)为0.08±0.02 vs 0.03±0.02、血浆(mL)为7.96±2.76 vs 5.02±3.19、血小板(mL)为0 vs 0(均为P>0.05);术后机械通气时间(h)为3.64±4.14 vs 3.35±1.91、ICU停留时间(d)为1.08±0.91 vs 0.99±0.85、术住院时间(d)为7.16±1.73 vs 7.14±1.78;术后远期肾功能衰竭发生率(%)为0 vs 0和死亡率(%)为0 vs 0 (均为P>0.05)。其中,TXA组和对照组术后远期痉挛的发生率为2.5%vs 0,有增加的趋势(P>0.05)。结论 TXA可有效降低ASD患儿的术后出血量,对围术期输血和近、远期不良事件的发生率和死亡率影响甚小。展开更多
Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia.Patient blood management(PBM)is an evidence-based,multidisciplinary approac...Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia.Patient blood management(PBM)is an evidence-based,multidisciplinary approach to optimizing the care of patients who may need transfusion,which encompasses anemia management,hemodilution,cell salvage,hemostatic treatment,and other approaches to reducing bleeding and minimizing blood transfusion.PBM in cardiovascular surgery is a"team sport"that involves cardiac and vascular surgeons,anesthesiologists,perfusionist,intensivists,and other health care providers.The current work provides an overview of evidence and practice of PBM at Fuwai Hospital.Implementation of PBM should also take local resource availability and costeffectiveness of different devices,drugs,technologies,and techniques into consideration.展开更多
文摘目的评价氨甲环酸(TXA)对房间隔缺损(ASD)患儿围术期的血液保护作用及对不良事件发生率和死亡率的近期与长期影响。方法回顾性队列研究:连续选取本院2009年1月—2010年12月接受ASD修补术的单纯ASD患儿224名,根据术中是否应用TXA被分TXA组(n=96)和对照组(n=128),年龄2个月—6(3.23±2.22)岁,美国麻醉师协会(ASA)分级为1—2级;在术后第7年电话随访患儿及其家属。记录并统计分析患儿主要的围术期出血和输血及术后近远期不良事件的发生率和死亡率。结果对照组和TXA组ASD患儿出血量(mL):术中59.83±2.11 vs 62.01±2.44(P>0.05),术后99.47±3.86 vs 85.97±4.46(P<0.05);输血量:红细胞(U)为0.08±0.02 vs 0.03±0.02、血浆(mL)为7.96±2.76 vs 5.02±3.19、血小板(mL)为0 vs 0(均为P>0.05);术后机械通气时间(h)为3.64±4.14 vs 3.35±1.91、ICU停留时间(d)为1.08±0.91 vs 0.99±0.85、术住院时间(d)为7.16±1.73 vs 7.14±1.78;术后远期肾功能衰竭发生率(%)为0 vs 0和死亡率(%)为0 vs 0 (均为P>0.05)。其中,TXA组和对照组术后远期痉挛的发生率为2.5%vs 0,有增加的趋势(P>0.05)。结论 TXA可有效降低ASD患儿的术后出血量,对围术期输血和近、远期不良事件的发生率和死亡率影响甚小。
基金partially funded by CAMS Innovation Fund for Medical Sciences (CIFMS)(2021-I2MC&T-B-038)
文摘Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia.Patient blood management(PBM)is an evidence-based,multidisciplinary approach to optimizing the care of patients who may need transfusion,which encompasses anemia management,hemodilution,cell salvage,hemostatic treatment,and other approaches to reducing bleeding and minimizing blood transfusion.PBM in cardiovascular surgery is a"team sport"that involves cardiac and vascular surgeons,anesthesiologists,perfusionist,intensivists,and other health care providers.The current work provides an overview of evidence and practice of PBM at Fuwai Hospital.Implementation of PBM should also take local resource availability and costeffectiveness of different devices,drugs,technologies,and techniques into consideration.
