摘要
目的:探讨成人肝移植术中血小板输注的影响因素。方法:回顾性收集南京大学医学院附属鼓楼医院2018年1月至2019年12月同一肝移植团队进行的163例肝移植患者临床资料,根据患者术中是否输注血小板分为血小板未输注组(58例)和血小板输注组(105例),比较2组患者的一般情况、术前指标以及术中基本情况。以术中是否输注血小板为因变量,以单因素分析结果中差异有统计学意义的影响因素为自变量,进行logistics回归分析,确定肝移植术中血小板输注的独立危险因素。结果:(1)单因素分析结果显示,肝病诊断、上腹部手术史、血小板减少症、肝性脑病、腹水、Hb、HCT、PLT、WBC、INR、PT、APTT、PT、TT、Fib、TBIL、DBIL、TP、MELD评分、手术时间、术中失血量与术中血小板输注存在相关性(P<0.05)。(2)logistics回归分析发现,术前PLT(OR=0.977,95%CI:0.968~0.986,P<0.05)是成人肝移植术中血小板输注的保护因素,术中失血量(OR=1.0003,95%CI:1.0001~1.0005,P<0.05)和术前TBIL(OR=1.006,95%CI:1.002~1.009,P<0.05)是成人肝移植术中血小板输注的独立危险因素。结论:本回顾性研究提示成人肝移植术中血小板输注的独立危险因素为术中失血量和术前TBIL,PLT是保护因素。
Objective:To explore the influencing factors of platelet transfusion in adult liver transplantation.Methods:Clinical data were retrospectively analyzed for 163 patients undergoing liver transplantation performed by the same surgical team of our hospital from Affiliated Drum Tower Hospital Nanjing University Medical School from January 2018 to December 2019.According to intraoperative platelet transfusion,the patients were divided into platelet non-transfused group(n=58)and platelet transfused group(n=105).The general conditions,preoperative indexes and intraoperative basic conditions of the two groups of recipients were compared.Using intraoperative platelet transfusion as the dependent variable and influencing factors with statistically significant differences in univariate analysis results as the independent variables,Logistics regression analysis was conducted to determine the independent risk factors for platelet transfusion during liver transplantation.Results:(1)Univariate analysis results showed that diagnosis of liver disease,history of upper abdominal surgery,thrombocytopenia,hepatic encephalopathy,ascites,Hb,HCT,PLT,WBC,INR,PT,APTT,PT,TT,FiB,TBIL,DBIL,TP,MELD score,operation time and intraoperative blood loss were correlated with intraoperative platelet transfusions(P<0.05).(2)Logistics regression analysis showed that preoperative PLT(OR=0.977,95%CI:0.968-0.986,P<0.05)was a protective factor for platelet transfusion in adult liver transplantation,while intraoperative blood loss(OR=1.0003,95%CI:1.0001-1.0005,P<0.05)and preoperative TBIL(OR=1.006,95%CI:1.002-1.009,P<0.05)were independent risk factors of platelet transfusion in adult liver transplantation.Conclusion:This retrospective study suggests that the independent risk factors for platelet transfusion during adult liver transplantation are intraoperative blood loss and preoperative TBIL,while PLT is a protective factor.
作者
陈杰
李平
刘婷婷
李亚峰
刘潺
闫保娟
韩晶晶
CHEN Jie;LI Ping;LIU Tingting;LI Yafeng;LIU Chan;YAN Baojuan;HAN Jingjing(Department of Blood Transfusion,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,210008,China;Clinical Laboratory,Children's Hospital of Nanjing Medical University)
出处
《临床血液学杂志》
CAS
2022年第6期393-397,401,共6页
Journal of Clinical Hematology
基金
南京医学科技发展项目(No:YKK18059)。
