135例肝移植患者围术期输血情况分析  

Blood Transfusion in the Patients with Perioperation of Liver Transplantation

作　　者：王淑英[1] 牛国涛[1] 刘振红[1] 冯艳青[1] 张雷英[1] 叶艳菲[1] 刘志国[1] 

机构地区：[1]解放军第302医院临床输血中心,北京100039

出　　处：《临床输血与检验》2015年第2期135-138,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的分析135例原位经典肝移植患者在围术期的用血情况,为原位肝移植合理输血和备血提供依据。方法分析本院2010~2013年进行的135例原位肝移植患者围术期各阶段的输血率、输血量、红细胞与血浆的比例,并采用多元回归分析术中输血量的影响因素。结果 135例肝移植患者中,术前、术中和术后输血率分别是15.6%、100.0%、80.0%;围术期人均用血总量为4 808.8ml,术前、术中和术后分别占3.2%、72.0%和24.8%,术前、术中和术后的红浆比例分别为0.59∶1,0.95∶1,2.43∶1。经过多元线性回归分析发现,术中红细胞的输注量与上腹部手术史、血红蛋白和凝血酶原时间活动度相关。结论原位肝移植患者围术期血液的需求主要在术中,术前以应用血浆为主,术中和术后以应用红细胞为主。对于有上腹部手术史、血红蛋白低和凝血酶原时间活动度低的患者,手术备血时建议多备一些。Objective To offer reference of blood transfusion to orthotopic liver transplantation during perioperation in135 cases.Methods The proportion of the red blood cells to plasma,frequency and volume of blood transfusion were calculated in sveral stages of liver transplantation and the factors affecting the amount of blood transfusion were analyzed by multiple regression analysis.Results The frequency of blood transfusion in pre-,intra-and post-operation were 15.6%,100%,and 80%,respectively.The average amount of blood transfused was 4 808.8ml,accounting for 3.2%,72%,and24.8%in each.The proportion of red blood cells to plasma was 0.59：1,0.95：1,and 2.43：1.Multiple linear regression analysis showed that the volume of transfused erythrocytes in intraoperation was related to the history of upper abdominal surgery,hemoglobin and prothrombin time activity.Conclusions The demand of blood for patients with orthotopic live transplantation was mainly for surgery in preoperation,and plasma was routinely used.Transfusion of red blood cells,however,is preferential in intra-or post-operation.For the patients with the history of upper abdominal surgery,low hemoglobin and prothrombin time activity,sufficient volume of blood should be prepared.

关 键 词：成分输血 肝移植 围手术期 

分 类 号：R457.1[医药卫生—治疗学]