围手术期输血对原发性肝癌患者预后的影响  

The Influence of Perioperative Blood Transfusion on the Prognosis of Patients with Primary Carcinoma of the Liver

作　　者：叶先仁[1] 刘景福[1] 卢荣[1] 黄彦[1] 

机构地区：[1]福建省肿瘤医院输血科,福州350014

出　　处：《临床输血与检验》2013年第2期128-131,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨围手术期输血对原发性肝癌患者预后的影响。方法收集在本院进行手术治疗的130例原发性肝癌患者,根据输注的血液成分不同分为悬浮红细胞组、血浆组和未输血组,采用Kaplan-Meier法分析比较各组患者的生存率,Cox回归分析影响患者预后的独立危险因素。结果悬浮红细胞组患者术后1年、3年、5年生存率分别为72.9%、27.1%、14.6%,血浆组患者术后1年、3年、5年生存率分别为82.4%、32.4%、15.7%,未输血组患者1年、3年、5年生存率分别为89.2%、37.8%、24.8%,未输血组的生存率高于悬浮红细胞组,差异有统计学意义(P=0.037)。多因素Cox回归分析发现,肝功能Child分级、有无癌栓、有无播散结节、肿瘤TNM分期等是影响患者术后生存率的独立危险因素。结论围手术期输血能够影响患者的总体生存率,但围手术期输血不是影响患者生存率的独立危险因素。Objective To investigate the influence of perioperative blood transfusion on the prognosis of patients with primary carcinoma of the liver. Methods 130 patients who had undergone curative hepatic resection were devided into three groups, RBC group （n = 59）, FFP group （n = 34） and non-transfusion group （n ： 37）. The overall survival rates of three groups were evaluated with Kaplan-Meierand univariate log-rank test. The multivariate analysis was performed by Cox proportional hazards model. Results The 1-,3-,5-year overall survival rates in RBC group were 72.9%,27. 1%, 14. 6%, respectively, 82.4%,32.4%,15. 7% in FFP group and 89.2%,37.8%,24.8% in non-transfusion group. The overall survival rates of non-tranfusion group were higher significantly than RBC group, P= 0. 037. Multivariate analysis showed that Child-Pugh, TNM stage, vascular invasion and satellitenodule were independent prognostic risk factors for overall survival. Conclusion The overall survival rate of non-blood tranfusion is higher than blood tranfusion groups. However, perioperative blood tranfusion is not one of independent prognostic risks.

关 键 词：输血 生存率 原发性肝癌 围手术期 

分 类 号：R826.26[医药卫生—临床医学] R735.7