摘要
目的分析肺部肿瘤患者围手术期高需求输血的原因,探究高需求输血的预测因素及对患者术后恢复的影响。方法回顾性分析2007年11月至2017年10月中国医学科学院肿瘤医院胸外科行肺部肿瘤手术患者的资料,以围手术期红细胞输入量≥5U为标准,共计83例患者作为高需求输血组,其余输血患者中匹配筛选83例作为普通需求输血组,统计相关临床资料及输血情况,分析高需求输血原因及对术后恢复的影响,并对高需求输血相关因素进行单因素及多因素logistic回归分析。结果2007年11月至2017年10月我院胸外科肺部肿瘤手术共23898例,高需求输血率为0.35%。前5年与后5年比较,高需求输血比例为0.61%(46/7503)对0.23%(37/16395)(P<0.01);高需求输血组与普通需求输血组比较,胸腔镜手术比例分别为42.17%(35/83)对26.51%(22/83)(P<0.05),术后出血比例分别为39.76%(33/83)对22.90%(19/83)(P<0.05),左肺上叶手术比例分别为24.10%(20/83)对12.05%(10/83)(P<0.05);高需求输血组与普通需求输血组比较,术前存在合并症患者比例分别为21.69%(18/83)对8.43%(7/83)(P<0.05),存在贫血患者比例分别为57.83%(48/83)对52.63%(30/83)(P<0.01);高需求输血组与普通需求输血组比较,术后并发症发生率分别为39.76%(33/83)对18.07%(15/83)(P<0.01),其中感染相关并发症发生率分别为25.30%(21/83)对8.43%(7/83)(P<0.01)。结论肺部肿瘤患者围手术期高需求输血在不同手术方式、手术部位及输血时相上均存在显著差异,且会增加术后并发症的风险,术前存在合并症或贫血是其预测因素。
Objective To analyze the causes and correlative factors of high perioperative blood transfusion demand in patients with lung tumor,and to discuss the influence of high blood transfusion demand on patients’postoperative recovery and its predictive factors.Methods From November 2007 to October 2017,clinical data of patients who had underwent surgery for lung tumors in the Department of Thoracic Surgery,Cancer Hospital,Chinese Academy of Medical Sciences were collected.A total of 83 cases with perioperative transfusion of red blood cells≥5U were classified as high transfusion demand group.Another 83 cases were selected from the rest of the patients with transfusion of red blood cells<5U as normal transfusion demand group.Related clinical and transfusion data were summarized to analyze the causes of high blood transfusion demand and its effect on postoperative recovery,univariate and multivariate logistic regressions were used to analyse correlative factors.Results From November 2007 to October 2017,23898 patients with lung tumor underwent surgery in our department and the high blood transfusion demand rate was 0.35%.In the last 10 years,the ratio of high transfusion demand was 0.61%(46/7503)in the first 5 years versus 0.23%(37/16395)in the later 5 years(P<0.01).By contrasting high transfusion demand group and normal transfusion demand group,the ratio of thoracoscopic surgery was 42.17%(35/83)vs.26.51%(22/83)(P<0.05),the ratio of postoperative blood transfusion was 39.76%(33/83)vs.22.90%(19/83)(P<0.05)and the ratio of left upper lung surgery was 24.10%(20/83)vs.12.05%(10/83)(P<0.05).The ratio of patients with preoperative comorbidities was 21.69%(18/83)in the high transfusion demand group versus 8.43%(7/83)in the normal transfusion demand group(P<0.05),and the ratio of patients with anemia was 57.83%(48/83)vs.52.63%(30/83)(P<0.05).The incidence of complications was 39.76%(33/83)in the high transfusion demand group versus 18.07%(15/83)in the normal transfusion demand group(P<0.01),and the incidence of Infection-re
作者
曾庆鹏
李嘉根
律方
黄进丰
张良泽
高树庚
赵峻
Zeng Qingpeng;Li Jiagen;Lyu Fang;Huang Jinfeng;Zhang Liangze;Gao Shugeng;Zhao Jun(Department of Thoracic Surgery,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100021,China)
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2019年第10期603-607,共5页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
肺部肿瘤
高需求输血
影响因素
术后并发症
Lung tumor
High blood transfusion demand
Influencing factor
Postoperative complications
