摘要
目的:探讨输注大量长期储存的浓缩红细胞(PRBCs)是否会增加创伤和非创伤外科手术患者的死亡率,以及储存时间对创伤和非创伤这2种手术是否有不同的影响。方法:选取2014-01-2016-01收治的496例24h内给予输注≥10单位PRBCs的患者进行回顾性分析,用多因素Logistic回归分析PRBCs平均储存时间和住院死亡率的关系,用限制3次样条函数评估关系中的潜在非线性,以及分析手术类型(创伤与非创伤)和储存时间对结果的影响。结果:305例患者总共输注8 046单位的PRBCs,持续时间8~36d(22±6)d。住院死亡率均与对应的PRBCs储存时间的比率为0.99d(0.95,1.03,P>0.05)。PRBCs储存时间和死亡率的关系在创伤和非创伤患者间差异无有统计学意义(P>0.05)。调整多个潜在混杂因素后,结果仍相似。结论:患者术后输注长时间保存的浓缩红细胞没有增加死亡率。创伤和非创伤患者对PRBCs储存时间的易感性没有差别。
Objective：To investigate whether infusion of prolonged packed red blood cells（PRBCs）can increase the mortality of trauma and non invasive surgical patients,and whether the storage time has different effects on the two operations,trauma and non trauma.Method：A retrospective analysis was made of 496 patients who received the infusion of PRBCs within 24 hours from January 2014 to January 2016.We considered surgical patients given more than 10 units of PRBC within 24 hours and evaluated the relationship between mean PRBC storage duration and in-hospital mortality using multivariable logistic regression.Potential nonlinearities in the relationship were assessed via restricted cubic splines.The secondary hypothesis was evaluated by considering whether there was an interaction between the type of surgery（trauma versus nontrauma）and the effect of storage duration on outcomes.Result：305 patients were given a total of 8,046 units of PRBCs,with duration ranging from 8 to 36 days（mean±SD：22±6 days）.The odds ratio [95% confidence interval（CI）]for in-hospital mortality corresponding to a one-day in mean PRBCs storage duration was 0.99（0.95,1.03,P=0.77）.The relationship did not differ for trauma and nontrauma patients（P=0.75）.Results were similar after adjusting for multiple potential confounders.Conclusion：Mortality after massive blood transfusion was no worse in patients transfused with PRBC stored for long periods.Trauma and nontrauma patients did not differ in their susceptibility to prolonged PRBC storage.
作者
许娜
刘飞
黄伟
XU Na;LIU Fei;HUANG Wei(Department of Blood Transfusion,Affiliated Hospital of Yaffan University,Yaffan, 716000,China)
出处
《临床血液学杂志（输血与检验）》
CAS
2018年第2期270-275,共6页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
基金
陕西省延安市科技惠民计划(No:2015HM-06-01)
关键词
浓缩红细胞
长期存储
输血
创伤患者
非创伤患者
packed red blood cells
prolonged storage
blood transfusion
trauma patients
nontrauma patients
