- 期刊
以病患血紅素探討輸血決策點與輸血目標值
Using Patient Hemoglobin Level to Explore Transfusion Decision Points and Target Values
摘要
目的：輸血在臨床上是治療貧血的一種方式，判斷病患是否需要輸血常以抽血檢驗病患的血紅素濃度，如何適當地使用成分血品是目前臨床上重視的議題。本研究將以病患輸血前、後的病患平均血紅素濃度來分析成分紅血球血品使用的情況。方法：本研究採用回溯性研究方法，共收集3037筆資料。並收集所有病患在輸血前後一周內最近一次血紅素濃度報告，並以獨立樣本t檢定、單向ANOVA分析進行平均血紅素濃度的差異分析。結果：內、外科系輸血前平均血紅素濃度為7.3±1.5 g/dL及9.6±2.1 g/dL，輸血後平均血紅素濃度8.9±1.7 g/dL及10.3±1.8 g/dL，且有顯著差異(P＜0.01)。急診內科病患輸血前、後平均血紅素濃度為6.9±1.5 g/dL及8.2±1.6 g/dL，低於門診輸血前、後平均血紅素濃度7.4±1.4 g/dL及8.8±1.9 g/dL，和住院病患輸血前、後平均血紅素濃度7.4±1.6 g/d及9.2±1.7 g/dL，三者且有顯著差異(P＜0.01)。內科系81歲以上病患輸血前、後的平均血紅素濃度為7.4±1.3 g/dL及9.1±1.6 g/dL高於17-40歲病患輸血前、後的平均血紅素濃度6.9±1.3 g/dL及8.6±1.1 g/dL，且有顯著差異(P＜0.01)。內、外科男性病患在輸血前、後平均血紅素濃度為7.3±1.7 g/dL、8.8±1.7 g/dL、9.5±2.3 g/dL及10.3±2.0 g/dL和內、外科女性病患在輸血前、後平均血紅素濃度7.3±1.4g/dL、9.1±1.6g/dL、9.7±2.0g/d及10.4±1.6g/dL，無顯著差異(P＞0.05)。結論：內科和外科在輸血決策點和輸血目標值的結果具有差異。本研究發現大部分內科次專科在輸血決策點和輸血目標值具有共識。而內、外科輸血決策點和輸血目標值不會因為性別不同而有所差異，與病患年齡多寡和對貧血的耐受性較具關連性。
並列摘要
Objective: Blood transfusion is a way to treat anemia in the clinic. Often test hemoglobin to decide whether to transfusion. How to properly use blood product is currently a topic of clinical importance. This study will use the hemoglobin level of patients before and after transfusion to analyze the use of red blood cell product. Methods: This research uses a retrospective study. A total of 3037 information were collected. And collect the latest hemoglobin level for all patients within one week before and after the blood transfusion. Difference analysis of hemoglobin level was analyzed using independent sample t-test, one-way ANOVA. Results: The average hemoglobin levels before transfusion of medical and surgical departments were 7.3±1.5 g/dL and 9.6±2.1 g/dL, The average hemoglobin levels after transfusion of medical and surgical departments were 8.9±1.7 g/dL and 10.3±1.8 g/dL, There were significant differences between the two groups (P＜0.01). The average hemoglobin levels before and after blood transfusion in emergency department patients were 6.9±1.5 g/dL and 8.2±1.6 g/dL. Lower than the average hemoglobin levels before and after outpatient blood transfusion 7.4±1.4 g/dL and 8.8±1.9 g/dL and the average hemoglobin levels before and after transfusion in patients and inpatients were 7.4±1.6 g/d and 9.2±1.7 g/dL. There were significant differences among the three groups (P＜0.01). The average hemoglobin levels before and after transfusion in patients with medical treatment over 81 years of age was 7.4±1.3 g/dL and 9.1±1.6 g/dL is higher than the average hemoglobin levels before and after transfusion in patients aged 17 to 40 was 6.9±1.3. g/dL and 8.6 ± 1.1 g/dL, There are significant differences (P＜0.01). Medical and surgical male patients' average hemoglobin levels before and after transfusion are 7.3±1.7 g/dL、8.8±1.7 g/dL、9.5±2.3 g/dL and 10.3±2.0 g/dL, Medical and surgical female patients' average hemoglobin levels before and after transfusion are 7.3±1.4 g/dL、9.1±1.6 g/dL、9.7±2.0 g/dL and 10.4±1.6 g/dL, There was no significant difference (P＞0.05). Conclusions: There are differences in the results of blood transfusion decision points and transfusion target values in internal medicine and surgery. This study found that most medical specialists have a consensus on transfusion decision points and transfusion target values. The internal medicine, surgical transfusion decision points, and blood transfusion target values will not differ by gender. It is related to the age of the patient and the tolerance to anemia.