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【Objective】 To analyze the impact of preoperative anemia on perioperative red blood cell transfusion and prognosis of children undergoing septal defect repair. 【Methods】 The medical records of 208 patients under 18 years old with septal defect, i. e. ventricular septal, atrial septal, ventricular septal with atrial septal defect, in a hospital from December 2018 to March 2022 were collected. They were divided into anemic group (n=52) and non-anemic group (n=156) according to whether they were anemic before operation. The basic information, as well as preoperative, intraoperative and postoperative blood transfusion, postoperative ICU stay, postoperative infection rate and average length of stay were compared between the two groups. 【Results】 The incidence of preoperative anemia in the children with septal defect was 25.0% (52/208). The age, preoperative body weight(kg) and hemoglobin (g/L) of anemic group and non-anemic group was 0.67(0.33, 2) vs 2(1, 3), 6.5(5, 10) vs10.5(8, 14) and 102(91.5, 107) vs 127(121, 134) respectively, all P<0.05. Preoperative, intraoperative and postoperative blood transfusion rates in the anemic and non-anemic groups were 11.54% (6/52) vs 0% (0/156), 92.31% (48/52) vs 72.44% (113/156), 51.92% (27/52) vs 25.0% (39/156), all P<0.05. Postoperative ICU stay (d) and mean length of stay(d) of anemia group and non-anemia group was 3 (2, 6) vs 2 (2, 3) and 19(13, 25) vs14(11, 18) respectively, P<0.05. 【Conclusion】 Preoperative anemia is an important factor affecting perioperative red blood cell transfusion in children with septal defect repair, and also an important reason for prolonging postoperative ICU stay and hospital stay.
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【Objective】 To analyze the characteristics and influencing factors of blood transfusion in patients undergoing hepatectomy with hydatid hepatica, so as to provide perioperative blood security of these patients. 【Methods】 A retrospective analysis was performed on 40 hydatid hepatica patients who underwent hepatectomy from June 2011 to June 2021, and they were divided into the transfusion group (n=15) and the non-transfusion group (n=25). The difference in basic information, operative information, blood routine, coagulation function, biochemical parameters and thromboelastogram between the two groups were compared, and the characteristics of perioperative blood transfusion were analyzed. 【Results】 Fifteen(37.5%, 15/40) patients undergoing hepatectomy received blood transfusion, among which 2(5%, 5/40), 10(25%, 10/40) and 11(27.5%, 11/40) received preoperative, intraoperative and postoperative transfusion, respectively. The average transfusion of suspended red blood cells, plasma and cryoprecipitate were 4.77 U, 1 355 mL and 11.9 U respectively, without any adverse reactions of blood transfusion occurred. The operative time, intraoperative blood loss, the number of patients with tumor diameter ≥10 cm/ diameter <10 cm, the number of patients with cholecystectomy, postoperative PT, postoperative APTT and average hospital stay in the transfusion group were higher than those in the non-transfusion group(P<0.05), and the postoperative FIB was lower than those in the non-transfusion group(P<0.05). The blood test results showed that the WBC, AST, ALT and INR 24h after operation were significantly higher than those before operation (P<0.05), while RBC, Hb, ALP, FIB and Angle were significantly lower than those before operation(P<0.05). There were statistically significant differences in WBC, RBC, Hb, ALT, ALP and INR between preoperative and postoperative 3~5 days(P<0.05). The differences of WBC, AST, ALT and FIB 3~5 days after surgery were statistically significant compared with 24 hours after surgery(P<0.05). 【Conclusion】 The size of hepatic hydatid mass, cholecystectomy, intraoperative blood loss, operative time, postoperative PT, postoperative APTT and postoperative FIB were important factors affecting perioperative blood transfusion after hepatectomy, and the main transfusion components were plasma and cryoprecipitate.
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【Objective】 To analyze the safety of apheresis granulocyte(AG) collection from blood donors mobilized by G-CSF and apheresis granulocyte transfusion efficacy in patients. 【Methods】 The blood routine results, collection process and follow-up of blood donors mobilized by G-CSF before and after AG collection were collected to analyze the safety of AG collection, and the blood routine results, clinical symptom improvement and treatment outcome of patients before and after AG transfusion were collected to analyze the transfusion efficacy. 【Results】 A total of 27 blood donors donated 29 U AG, with collection time at (229±20)min, circulating blood volume at (9 890±1 107)mL, and the dosage of anticoagulant at (1 002±97)mL.Two blood donors had adverse reactions to blood donation, and the AG collection was carried out after treatment.After G-CSF mobilization, WBC increased significantly from (5.61±1.06) ×109/L to (22.85±5.23) ×109/L, while RBC, Hb, Hct and Plt showed no significant change.The blood routine returned to the level before G-CSF mobilization 1-2 days after blood donation.No physical discomfort occurred during the one week after blood donation.Four patients with granulocyte deficiency complicated with multidrug-resistant bacterial infection, who failed to respond to antibiotic treatment, were transfused with 29 U AG, with no adverse reactions and no obvious change in blood routine, but the infection symptoms were improved significantly judged from clinical manifestation, bacterial culture results, temperature monitoring and CT examination, suggesting that the AG infusion was effective.Among the 4 patients, 1 was cured and discharged, 1 gave up treatment, 1 died of sepsis, and 1 died of multiple organ failure. 【Conclusion】 It is safe to collect AG from blood donors mobilized by G-CSF through blood cell separator, and the AG products basically meet the national quality requirements and the treatment needs.Sustained high-dose AG transfusion has a significant effect on infection control in patients with agranulocytosis combined with refractory multidrug-resistant bacterial or fungal infection.
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【Objective】 To investigate the changes in peripheral blood routine in blood donors after multiple and frequent platelets donation. 【Methods】 A total of 228 voluntary blood donors who donated apheresis platelets for 5 or more times were selected. The results of peripheral blood routine testing before the first and most recent donation were collected. The data were analyzed in terms of blood donation volume, frequency of blood donation (total frequency/total months), and numbers of blood donation. 【Results】 1) There was statistical significance in the decrease of WBC counts when the accumulative volume of platelet donation >18 treatment doses and the number of blood donation >10 (P18, (P18 treatment doses, blood donation frequency ≥1, and the number of blood donation >18(P18 treatment doses (P0.05), and a significant lead in the Plt value of most recent donation was observed again until the blood donation volume reached ≥76 treatment doses (P1.4 and the number of blood donations≥40, the Plt value of the most recent donation was significantly higher than that of the first one(P18 treatment doses, blood donation frequency >1.4, and the number of donation >18, it is recommended to extend the donation interval and/or take iron supplements appropriately.
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【Objective】 To establish the maximum surgical blood order schedule(MSBOS) for orthopedic surgery, as to guide the clinical blood application and reasonable blood preparation for this type of surgery. 【Methods】 The ordered and actual amount of transfused blood of orthopedic elective operations in our hospital from 2014 to 2018 were collected by the hospital information(HIS) and blood collection information software of Department of Blood Transfusion.The surgeries were classified and indices, including blood transfusion rate and per capita transfused RBC volume, were calculated, then orthopedic MSBOS was established by combining the surgical transfusion rate, per capita red blood cell infusion volume, the algorithm of MSBOS, the risk of massive hemorrhage and the actual situation of our hospital. 【Results】 A total of 3 730 cases of elective orthopedic surgery were included, and the ordered blood volume was 10 183.8 U. 1084 cases received intraoperative blood transfusion, with the total blood transfusion volume of 3 498.8 U and the blood transfusion rate at 29.1%(1 084/3 730). The blood transfusion volume of surgical patients was [1~17.5(3.21±1.89)] U/patient. MSBOS for orthopedic surgeries had been established in our hospital. According to the blood transfusion data of each surgical procedures, surgical blood ordering was divide into 2 categories: Type/Screen, Type/Screen/Crossmatch (2~8 U). 【Conclusion】 The establishment of MSBOS in Department of Blood Transfusion according to the daily blood use in orthopedic surgery is not only beneficial to guide the blood preparation for orthopedics surgery more scientifically and reasonably, but also can optimize the management of blood inventory and provide reference for the establishment of MSBOS in other blood use departments.
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OBJECTIVE:To provide reference for promoting the application ofwhole course tutorial systemin the practice teaching of medical higher vocational colleges. METHODS:Totally 106 students on internships of medical higher vocational colleg-es were selected and randomly divided into control group(n=53)and observation group(n=53). Control group received routineteaching method;observation group receivedwhole course tutorial systemteaching method on the basis of control group. Score, teaching quality and students'satisfactory degree were compared between 2 groups after the end of internship teaching. RESULTS:The scores of autonomous learning ability,comprehensive ability,communication ability,judgment ability,thinking and solving problem ability and total score in observation group were all significantly higher than control group after the end of internship teach-ing;the proportion of good teaching quality in observation group was significantly higher than control group,manifesting as high practical ability,good adaptability,caring patient,good learning condition;the satisfactory degree of students in observation group was significantly higher than control group(98.11% vs. 88.68%),there was statistical significance(P<0.05). CONCLUSIONS:The implementation ofwhole course tutorial systemteaching method in practice teaching of medical higher vocational colleges based on conventional teaching method achieves ideal effect and can improve the students'learning effect,teaching quality and stu-dents'satisfactory degree.