Objective To explore the effects
of restrictive and liberal blood transfusion on the prognosis in elderly
patients undergoing different elective surgeries. Methods A total of 80 elderly
patients undergoing elective surgery in The First Dongguan Affiliated Hospital
of Guangdong Medical University from January 2019 to June 2021 were randomly
evenly divided into two groups using computer numbers. There were 26 males and
14 females in the control group, aged (64.82±2.71) years; there were 22 males
and 18 females in the observation group, aged (65.67±3.39) years. The patients
in the control group were given liberal blood transfusion when hemoglobin (Hb)
<100 g/L, while the patients in the observation group were given restrictive
blood transfusion when Hb <70 g/L. The safety and efficacy indexes of the
two groups were recorded and compared before surgery (T0), at the end of
surgery (T1), 1 day after surgery (T2), and 7 days after surgery (T3). t test was used for the measurement data
and χ2 test was used for
the count data. Results At T0, there were no statistically significant differences in the
mean arterial pressure (MAP), heart rate (HR), Hb, international standardized
ratio of prothrombin time (PT-INR), and creatinine (Crea) between the two
groups (all P>0.05). At T1, T2,
and T3, there were no statistically significant differences in the MAP, HR,
PT-INR, and Crea between the observation group and the control group (all P>0.05); the Hb levels of the
observation group were (81.50±12.17) g/L, (101.60±8.33) g/L, and (117.45±18.23)
g/L, which were significantly lower than those of the control group
[(109.00±11.23) g/L, (125.33±9.34) g/L, and (136.50±25.55) g/L], with statistically
significant differences (all P<0.05).
At T0, there were no statistically significant differences in the cerebral
arterial blood oxygen content (CaO2), cerebral oxygen uptake rate
(CEO2), lactic acid (Lac), and Mini-Mental State Examination (MMSE)
score between the two groups (all P>0.05).
At T1, T2 and T3, there were no statistically significant differences in the
CaO2, CEO2, and Lac between the observation group and the
control group (all P>0.05). At T2
and T3, the MMSE scores in the observation group were (24.04±1.91) points and
(27.32±2.14) points, which were significantly higher than those in the control
group [(21.81±2.48) points and (23.51±2.31) points], with statistically
significant differences (both P<0.05).
The blood transfusion volume and incidence of complications in the observation
group were (2.08±0.26) U and 5.00% (2/40), respectively, which were lower than
those in the control group [(3.17±0.83) U and 15.00% (6/40)], with
statistically significant differences (both P<0.05). Conclusion Restrictive blood transfusion for elderly patients undergoing
elective surgery can effectively balance the level of cerebral oxygen
metabolism, maintain the stability of circulation, and promote the recovery of
cognitive function.
