Effectiveness Of Autologous Blood Transfusion For Middle-aged And Elderly Patients Undergoing Posterior Lumbar Surgery

Purpose Retrospective case analysis.Objective to investigate the effectiveness of autologous blood transfusion in middle-aged and elderly patients undergoing posterior lumbar surgery.The difference between the use of Autologous blood transfusion(ABT)and the system of autologous blood transfusion(transfusion,ABT)in the middle-aged and elderly patients in our department was compared.Methods A retrospective data collection was made for the middle-aged and elderly patients who were hospitalized at the Affiliated Union Hospital of Fujian Medical University from March 2016 to September 2017 and received posterior lumbar surgery.All the patients were selected according to the established criteria and exclusion criteria,all of which were performed by the same surgeon with the same surgeon.The lumbar posterior approach was used.The decompression segment was 1 to 2 segments,and a total of 104 patients were determined.During this period,the blood transfusion practice was divided into three different observers: group A autologous blood transfusion group(ABT)(n=31): autologous blood transfusion system was used,intraoperative bleeding was returned to the patients after the Cell Saver 5+ system treated with anticoagulant and filtration,and the B group transfusion group(ARCT)(n=21): these patients received blood transfusion.Allogeneic red cell infusion(ARCT)was used to cope with intraoperative or postoperative anemia(Hb less than 70 g/dl or symptomatic anemia),without autologous blood conversion;group C blank control group(n=52): throughout the hospital,including the operation process,without any form of blood products.Blood transfusion indications refer to the "technical specification for clinical transfusion" formulated by the expert group of the Ministry of health.The baseline data of the patients,the amount of intraoperative bleeding,the amount of autologous blood transfusion,the amount of allogeneic blood transfusion,the amount of intraoperative urine,the amount of allogeneic blood transfusion,the hemoglobin,blood cell specific volume and decompression section first days before and after the operation,the flow rate of the first days after the operation,the total flow rate after the operation,postoperative complication,postoperative hospitalization and total hospitalization expenses.Wait.All research data were processed by SPSS 22 software(IBM,USA).Results There was no significant difference in sex ratio,age and BMI among all 104 patients(P > 0.05).In group A,1 decompression segments were compared with that of group B and P > 0.05,and no significant difference was found in group B.There were 2 decompression segments in group A and group B.The amount of hemorrhage in group A was less than that in group B,P was 0.03,less than 0.05,and the data of groups were statistically significant.The urine volume of group A was significantly higher than that of group B,and the difference was statistically significant(P < 0.05).There was no significant difference in the hemoglobin,hematocrit and intraoperative decompression segment between A and B groups(P > 0.05).There was no significant difference in the volume of drainage between the two groups of A and B first days after operation.The total drainage volume of B group was significantly higher than that of A group after operation(P < 0.05).As the C group had 1 decompression segments and no obvious complications,the bleeding volume and total postoperative drainage volume in group C were the lowest.In group A,the total hospitalization expenses and postoperative hospitalization days were less than those in group B,and the difference between the two groups P < 0.05 was statistically significant.As the A and B groups increased the cost of blood transfusion,the total hospitalization expenses were higher than those of C group.In group B,postoperative complications occurred in 2 cases,accounting for 9.52% of the total group.No postoperative complications were found in group A and group C.Conclusions It is safe,economical and feasible to use ABT to supplement the blood loss and correct anemia.It can reduce intraoperative bleeding and blood loss,reduce or avoid transfusion of blood,reduce or avoid the risk of blood transfusion,reduce postoperative complications,shorten postoperative hospital stay,reduce hospitalization,and reduce hospitalization.There is a total benefit of the cost.The results of this study are of guiding significance in formulating the strategy of perioperative autologous blood transfusion for routine adult posterior lumbar surgery.