评估烧伤患者手术治疗中确定出血量的经验和计算方法的有效性

E. V. Zinoviev, D. O. Vagner, A. E. Chukharev
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引用次数: 0

摘要

的相关性。确定术中出血量的问题在今天仍然具有相关性。由于现有的评估方法多种多样,优化输血治疗的问题仍然存在争议。意图。目的:评价瘢痕切除面积对全血细胞计数的影响,比较失血量计算方法与实际排血量计算方法的结果。方法:回顾性研究73例烧伤患者。所有患者都进行了早期手术切除并同时进行自体真皮成形术。为了达到研究目的,对干预区域的血红蛋白、红细胞压积、红细胞体积和数量的变化进行比较。这项前瞻性研究包括20名志愿者,他们捐献了450毫升全血。在这一组中,将捐献体积与计算出的失血量进行比较(根据PG. Budny和G.D. Warden)。通过Microsoft Office Excel 2007和IBM SPSS Statistics 20.0对所得数据进行描述性、参数性和非参数性统计处理。结果和讨论。根据回顾性分析,实际切除面积与术后全血细胞计数的变化并不一致。基于前瞻性分析的结果,我们能够揭示身体健康志愿者的实际失血量与血红蛋白浓度变化之间的相关性(PG. Budny)。失血量和红细胞压积下降之间没有类似的相关性(由G.D. Warden提供)。结论。根据本研究的结果,我们无法证实经验方法测定烧伤患者失血量的有效性。PG. Budny公式给出了健康志愿者失血量的代表性结果。然而,这种方法在燃烧学中的有效性还有待进一步研究。
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Evaluation of the effectiveness of empirical and computational methods for determining volumes of blood loss in the surgical treatment of burned patients
Relevance. The problem of determining intraoperative blood loss in combustiology remains relevant today. With the variety of existing methods of its assessment, the issue of optimizing transfusion therapy remains debatable. Intention. To evaluate effects of the eschar excision area on the complete blood count and to compare results of computational methods for determining volumes of blood loss with actual volumes of blood exfusion. Methodology. 73 burned patients were included in the retrospective study. Early surgical excision with simultaneous autodermoplasty was performed in all patients. To achieve the study purposes, the intervention areas were compared with changes in hemoglobin, hematocrit, volume and number of red blood cells. The prospective study included 20 volunteers who donated 450 ml of the whole blood. In this group, donated volumes were compared with calculated volumes of blood loss (according to PG. Budny and G.D. Warden). The data obtained were processed via Microsoft Office Excel 2007 and IBM SPSS Statistics 20.0 using descriptive, parametric and nonparametric statistics. Results and Discussion. According to the retrospective analysis, actual areas of excision were not consistently related to the changes in complete blood count in the postoperative period. Based on the results of prospective analysis, we were able to reveal correlations between actual volumes of blood loss and changes in hemoglobin concentrations in somatically healthy volunteers (by PG. Budny). There were no similar correlations between volumes of blood loss and decreased hematocrit (by G.D. Warden). Conclusion. According to the results of the study, we couldn't confirm the effectiveness of empirical methods for determining volumes of blood loss in burned patients. The PG. Budny formula gives representative results of blood loss volumes in healthy volunteers. However, the effectiveness of this method in combustiology requires further research.
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28
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