The Effectiveness Evaluation And Analysis Of Perioperative Goal-oriented Blood Transfusion For Major Orthopedics In Elderly Patients

Objective: Through the establishment of blood transfusion effectiveness ofassessment criteria, to evaluate and analysis the effectiveness of perioperative red bloodcell infusion for orthopedics in elderly patients. Methods:108ASA II or III patients ofboth sexes aged60~80yr scheduled for elective orthopedic surgery were randomlydivided into2groups: Group I (n=54), use traditional method of red blood cell infusion;group II (n=54), use goal-oriented by hemoglobin (Hb) and hematocrit (Hct) of red bloodcell infusion, comparison the changes of the hemoglobin (Hb), hematocrit (Hct), red bloodcell (RBC), platelet (PLT), prothrombin time (PT), coagulation live enzymes time (APTT),alveolar-arterial oxygen partial pressure [P(A-a)O2], oxygenation index (OI) and vigileomonitoring indicators after red blood cell composition transfusion before and after surgeryand wound healing time, days of hospitalization and ICU transferred rate, through theestablishment of blood transfusion-effectiveness of assessment criteria, to evaluatehemoglobin (Hb) and hematocrit (Hct) of the efficacy and safety of the goal-oriented redblood cell infusion in orthopedic elderly patients. Results: Two sets of statisticalefficiency of59.3%and72.2%respectively, no significant statistical difference betweenthe two (P＞0.05). Two groups of patients with alveolar-arterial oxygen partial pressureand oxygenation index was no significant statistical difference (P＞0.05). Compared withthe traditional red blood cell infusion group, the method goal-oriented by hemoglobin (Hb)and hematocrit (Hct) of red blood cell infusion group with higher red blood cell count(RBC), hemoglobin (Hb) and hematocrit (Hct), decreased prothrombin time (PT),activated partial thromboplastin time (APTT), shorter wound healing time andhospitalizations, ICU transferred rate decreased (P＜0.05). Conclusion: The method goal-oriented by hemoglobin (Hb) and hematocrit (Hct) of red blood cell infusion will bemore effective to improve the effectiveness of perioperative red blood cell infusion formajor orthopedics in elderly patients.