1601例外科输血患者红细胞输注量与死亡率相关性分析  

Correlation analysis of 1601 surgical transfusion and mortality in patients with red blood cell transfusions

作　　者：李荣芳[1] 陈家茂[2] 杨江存[3] 

机构地区：[1]丰城市中医院输血科,江西丰城331100 [2]海口市中医院输血科,海南海口570100 [3]陕西省人民医院输血科,陕西西安710068

出　　处：《实验与检验医学》2015年第1期11-15,共5页Experimental and Laboratory Medicine

摘　　要：目的联合国内20家大型综合医院多中心回顾性调研外科住院患者大量输血病历1601例,分析探讨红细胞输注量与患者死亡率的关联性。方法联合全国20家三级综合医院进行多中心回顾性分析大量输血病例资料,根据24h内或72h内红细胞输注量分为:0~4U、5~9U、10~14U、15~19U、20~24U、25~29U、30~39U、40~U,8个组段,对红细胞输注不同量患者死亡情况进行分析,研究红细胞输注量与患者死亡率的关系。结果 24h或72h内,红细胞输注总量≥10U后,患者死亡率随红细胞用量而增加,24h内红细胞应用10U^40U,死亡率为6.0%~38.9%;72h内红细胞应用10U^40U,死亡率为5.2%~28.0%;24h和72h红细胞在应用5U^9U组段者死亡率最低,分别是3.7%和2.3%;在0~4U组段,死亡率分别为7.3%和9.7%。结论外科住院患者大量输血时,24h或72h内红细胞输注量与死亡率有一定的关联性,患者死亡率随红细胞输注量增多而升高。Objective To explore the relationship between red blood cell transfusion volume and patients＇ mortality in massive blood transfusion. Methods Multicenter retrospective research was carried out on 1601 surgical inpatients who receiving massive blood transfusion in 20 large comprehensive hospitals in China. According to red blood cell transfusion volume within 24 hours or 72 hours, they are divided into 8 groups： 0-4U, 5-9U, 10-14 U, 15-19 U, 20-24 U, 25-29 U, 30-39 U, 40U-. The status of patients＇ death with different red blood cell transfusion volume was analyzed. Results Patients＇ mortality increases with the increase of red blood cell transfusion when total red blood cell transfusion volume ≥10U within 24 or 72 hours. Survival analysis based on different red blood cell transfusion volume was of statistical significance（χ^2=72.857, P0.001）. Logistic regression analysis reveals that red blood cell transfusion volume was an independent risk factor（OR=0.52; CI： 0.43-0.64; P0.01） for death of patients in massive blood transfusion. When red blood cells were transfused at 5U-9U volume within 24 and 72 hours, mortality is the lowest, which was 3.7% and 2.3% respectively. Conclusions During massive blood transfusion for surgical inpatients, there is some correlation between red blood cell transfusion volume within 24 or 72 hours and mortality of patients. Patients＇ mortality increases with the increase of red blood cell transfusion. Red blood cell transfusion volume, length of stay at hospital and intensive care unit constitute the independent risk factors for patients＇ death.

关 键 词：大量输血 红细胞 死亡率 回顾性分析 多中心 

分 类 号：R457.1[医药卫生—治疗学] R826.26[医药卫生—临床医学]