Chinese Medical Sciences Journal ›› 2022, Vol. 37 ›› Issue (3): 246-260.doi: 10.24920/004035

• 一切为了人民健康一一我们这十年: 特别报道 • 上一篇    下一篇

患者血液管理:阜外医院单中心证据和实践

姚允泰1,*(),袁昕2,何丽仙1,于宜平1,杜雨3,刘刚4,田丽娟1,马祖轩5,张永保6,马洁7   

  1. 1中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 麻醉中心
    2中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 成人心脏外科中心
    3中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 成人术后恢复室
    4中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 体外循环中心
    5中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 输血科
    6中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 血管中心
    7中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 药剂科
  • 收稿日期:2021-11-01 接受日期:2022-01-06 出版日期:2022-09-30 发布日期:2022-01-26
  • 通讯作者: 姚允泰 E-mail:yuntaiyao@126.com

Patient Blood Management: Single Center Evidence and Practice at Fuwai Hospital

Yuntai Yao1,*(),Xin Yuan2,Lixian He1,Yiping Yu1,Yu Du3,Gang Liu4,Lijuan Tian1,Zuxuan Ma5,Yongbao Zhang6,Jie Ma7   

  1. 1Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
    2Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
    3Department of Surgical Intensive Care Unit, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
    4Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
    5Department of Transfusion, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
    6Department of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
    7Department of Pharmacy Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
  • Received:2021-11-01 Accepted:2022-01-06 Published:2022-09-30 Online:2022-01-26
  • Contact: Yuntai Yao E-mail:yuntaiyao@126.com

摘要:

失血和输血是心血管外科及心血管麻醉的重要质控指标。患者血液管理(patient blood management,PBM)指基于循证医学证据对可能接受输血治疗的患者开展的包括贫血干预、血液稀释、血液回收、凝血管理等在内的多学科协作诊疗,以期尽可能减少血制品输注和改善患者预后。心血管外科开展PBM需心脏外科医生、血管外科医生、麻醉科医生、体外循环科医生、危重症科医生和其他医务工作者的团队合作。本文着重介绍了阜外医院PBM的证据和实践。临床在开展PBM时,需考虑机构的资源情况,包括设备、技术、药品、技能的可获得性以及花费效益比。

关键词: 出血, 输血, 心血管手术, 麻醉

Abstract:

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 cost-effectiveness of different devices, drugs, technologies, and techniques into consideration.

Key words: bleeding, blood transfusion, blood management, cardiovascular surgery, anesthesia

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