呼吸重症监护病房患者医源性失血与贫血的关系-东南大学学报医学版

呼吸重症监护病房患者医源性失血与贫血的关系

单位：南京军区南京总医院呼吸与危重医学科, 江苏南京 210002

分类号：R556

出版年·卷·期（页码）：2016·35·第一期（101-105）

摘要：

目的:分析呼吸重症监护病房患者贫血的危险性和医源性失血与贫血的关系。方法:回顾分析2011-2014年我科监护病房住院时间大于等于7 d的非明显出血、造血障碍的患者,统计其抽血量和血红蛋白的值。结果:贫血率为71.8%(244/340)。血液血红蛋白平均下降幅度为(5.9±17.2) g·L^-1,存活组出院时的血红蛋白高于死亡组(P<0.05),贫血与APACHEⅡ评分相关。血红蛋白日变化与日抽血量呈负相关,抽血量越大的组,血红蛋白下降越明显,日抽血量2 ml以下组血红蛋白的下降不明显。结论:患者的诊断性失血与贫血相关,小于2 ml的日抽血对患者血红蛋白影响不明显,贫血与病情危重、预后不良相关。

Objective:To analyze the relationship between the risk of anemia in respiratory intensive care unit(RICU) and the iatrogenic blood loss and anemia. Methods:Retrospectively analysed the patients hospitalized in the RICU of our hospital with the length ≥ 7 days of non-significant bleeding or hematopoietic disorders in 2011 to 2014, by the method of statistical value of their blood volume and hemoglobin. Results:The anemia rate was 71.8% (244/340). The average decline of blood hemoglobin was (5.9±17.2) g·L^-1. The hemoglobin in the survival group was higher than that in the death group(P<0.05), and the anemia was related to APACHEⅡ score. The hemoglobin daily change was negatively related to diagnostic blood loss, the more blood drawing was the more significantly hemoglobin decreased, while the decrease of hemoglobin was not obvious in the group of <2 ml blood drawing. Conclusion:The diagnostic blood loss is associated with anemia, and blood drawing <2 ml does not significantly affect hemoglobin. Anemia is associated with critical condition and poor prognosis.

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