Study on the Effect of Different Blood Transfusion Methods on Postoperative Regression in Elderly Orthopedic Surgery Patients

Wang Xiaoxiao; Zhang Ziwei; Kang Yiqun

doi:10.3969/j.issn.1004-5775.2024.04.008

Abstract：Objective:To observe the effect of different blood transfusion methods on postoperative regression in elderly ortho-pedic surgery patients.Methods:90 patients undergoing elective orthopedic surgery were divided into allogeneic transfusion group(Group A),autologous transfusion group(Group B),and autologous + allogeneic transfusion group(Group C)according to different intraoperative transfusion modes.After general anesthesia of the patients,blood was collected from radial artery to detect Hb and Hct values.Intraoperative blood loss,allogeneic blood transfusion,autologous blood transfusion,urine volume,operation time and fluid input were observed and recorded.Venous blood was collected preoperatively,postoperatively,and 1 d,3 d,and 5 d postoper-atively to detect CD3+,CD4+,and NK cell percentages by flow cytometry.The 15-item Quality of Recovery Scale(QoR-15)scores were recorded 1 d preoperatively,1 d,3 d,and 7 d postoperatively,and postoperative hospitalization time was recorded.Results:The bleeding volume of group C was significantly more than that of group B,and the difference was statistically significant(P＜0.05).The percentages of CD3+,CD4+,and NK cells in group A were significantly lower than those in the preoperative period after operation,and at 1 d,3 d,and 5 d postoperatively,and the differences were statistically significant(P＜0.05).The percentages of CD3+ and CD4+ cells at 1 d,3 d,and 5 d postoperatively in group B,the percentages of CD4+ cells at 3 d postoperatively in group C,and the percentages of CD3+ cells at 5 d postoperatively in group C were significantly higher than those in group A,and the dif-ferences were statistically significant(P＜0.05).QoR-15 scores were significantly higher than those in group A in groups B and C at 1 d and 3 d postoperatively,and the differences were statistically significant(P＜0.05).QoR-15 scores in Group C were signifi-cantly lower than those in Group B at 1 d and 3 d postoperatively,and the difference was statistically significant(P＜0.05).Multi-factorial regression showed that the postoperative hospitalization time in group B was significantly lower than that in group A,and the difference was statistically significant(P＜0.05).There was no statistically significant difference between the postoperative hos-pitalization time in group C and that in group A(P=0.69).Conclusion:Recovered autologous blood transfusion(IOCS)applied to el-derly orthopedic surgical patients can effectively promote patients'postoperative regression,improve the quality of early postopera-tive recovery,and shorten the duration of postoperative hospitalization relative to allogeneic blood transfusion.