بررسي مقدار مصرف فرآورده‌هاي خوني و عوامل موثر بر آن در جراحي عروق كرونر

The factors that affect blood and blood products usage in coronary artery graft surgery

زمينه و هدف: آگاهي از ميزان نسبي مصرف خون حين عمل جراحي عروق كرونر باعث بهبود توانايي مراكز انتقال خون در تأمين خون سالم و كافي مي‌شود. به‌همين‌منظور اين مطالعه با هدف تعيين فاكتورهاي موثر در ميزان نياز به خون در جراحي باي‌پس عروق كرونر انجام گرفت. روش بررسي: اين مطالعه‌ي مقطعي بر روي 317 نفر از بيماران تحت جراحي ايزوله عروق كرونر در اتاق عمل جراحي قلب بيمارستان امام‌خميني (ره) تهران از شهريور تا پايان بهمن 1396 انجام شده است. روش نمونه‌گيري در دسترس بوده است. متغيرهاي اين مطالعه با مراجعه به پرونده بيماران استخراج شدند. 0/05P< به‌عنوان معنادار گزارش شد. يافته‌ها: در اين مطالعه، 317 بيمار تحت عمل باي پس شريان كرونر مورد بررسي قرار گرفتند. 236 مورد (74/4%) مرد و باقي زن بودند. ميانگين تجويز گلبول قرمز فشرده شده در زنان 1/3±2/74 واحد و در مردان 1/09±2/24 واحد بوده است (0/001

Background: Coronary artery bypass surgery is one of the surgeries in which high blood transfusions are needed. About 20% of all surgical operations require a blood transfusion. Packed cell administration increases perioperative morbidity and mortality. In the United States, from every 1000 people, one has undergone a coronary artery bypass graft surgery, and it is estimated that around 800,000 coronary artery bypass grafts undergo each year. Knowledge about relative blood administration during coronary artery bypass graft surgery improves the ability of blood transfusion centers in healthy and adequate blood donations. For this purpose, this study was conducted to determine the effective factors in the need for blood in a coronary artery bypass graft surgery. Methods: This cross-sectional study was performed on 317 patients undergoing coronary artery bypass graft surgery in the heart surgery operating room of Imam Khomeini Hospital in Tehran, Iran, from September 2017 to February 2018. Sampling method has been available. The data of this study were extracted from patient files. The products analyzed in the study included packed cell, fresh frozen plasma and platelets. Demographic data, type of surgery, transfusion of blood and products, and hemoglobin level have been reported. P-value less than 0.05 was reported as meaningful. Results: In this study, 317 patients underwent coronary artery bypass graft surgery. 236 cases (74.4%) were male and the rest were women. The mean of administration of packed cell in women was 2.74±1.3 and in men it was 2.29±1.09 (P<0.001). The mean packed cell administration in patients with hemoglobin levels less than 10 g/dl was 3.27±1.8 and in patients with hemoglobin levels greater than 10 g/dl was 0.99±2.25 (P<0.0001). Conclusion: The present study showed that the mean transfusion of packed cells in women were more than men in coronary artery bypass graft surgery. Also, hemoglobin levels were the only factor that had a significant effect on infusion of packed cells.