肝移植及腹部多器官移植手术的成分输血  

Transfusion of blood components in liver transplantation and abdominal multiple organ transplantation

作　　者：林静霞[1] 苏凡[2] 罗宏山[3] 

机构地区：[1]中山大学附属第一医院输血科,广东省广州市510080 [2]中山大学附属第一医院内科门诊,广东省广州市510080 [3]中山大学附属第一医院1输血科,广东省广州市510080

出　　处：《中国组织工程研究》2016年第33期4957-4962,共6页Chinese Journal of Tissue Engineering Research

基　　金：广东省自然科学基金项目(2015A030306025);国家自然科学基金项目(81302549)~~

摘　　要：背景:肝移植及腹部多器官移植手术复杂,失血多,输血需求大。目的:探讨肝移植及腹部多器官移植的失血及输血特点和移植后生存率。方法:回顾性分析192例患者,研究比较移植开始后24 h内输血数据和移植后存活期。结果与结论:(1)192例患者中,其中肝移植177例,肝肾联合移植2例,腹部多器官移植13例。每例移植患者移植中平均失血量为(2 401.5±3 239.5)mL;移植开始后24 h内的平均红细胞输注量为(11.3±11.9)U;平均血小板输注量为(0.8±0.9)U;平均冷沉淀输注量为(10.7±11.7)U;平均血浆输注量为(2 805.5±1 393.1)m L。(2)肝癌组的红细胞、血小板、冷沉淀、血浆输注量明显少于肝衰竭组;肝硬化组的冷沉淀、血浆输注量明显少于肝衰竭组;肝癌组的血小板输注量明显少于肝硬化组;2013年7月至2015年6月期间移植的红细胞输注量明显少于2012年7月至2013年6月;肝硬化患者的肝移植出血量、红细胞、血浆输注量均明显多于肝硬化患者的多器官移植(均为P<0.05)。(3)肝病诊断类别和手术操作技术及熟练程度影响肝移植患者的出血量和输血量。肝移植及腹部多器官移植的不断改良,移植失血量和输血量均有所下降;与单纯肝移植相比,腹部多器官移植并未增加失血量和输血量。BACKGROUND： The liver transplantation and abdominal multiple organ transplantation are complicated surgeries, characterized by massive blood loss and high blood transfusion requirements. OBJECTIVE： To explore the characteristics of blood loss and blood transfusion in liver transplantation and abdominal multiple organ transplantation and post-operative survival rate. METHODS： Clinical data from 192 patients were retrospectively analyzed, including blood transfusion data with the first 24 hours after surgery and post-operative survival rate. RESULTS AND CONCLUSION： These 192 patients included 177 patients receiving liver transplantation, 2 patients receiving liver and kidney transplantation and 13 patients receiving abdominal multiple organ transplantation. The average intra-operative blood loss of each patient was （2 401.5±3 239.5） mL. The average infusion of red blood cells, platelet, cryoprecipitate and frozen plasma of each patient at the first 24 hours after surgery was （11.3±11.9）, （0.8±0.9）, （10.7±11.7） U and （2 805.5±1 393.1 ） mL, respectively. All kinds of blood infusion in the liver cancer group were obviously less than those in the hepatic failure group. The infusion of cryoprecipitate and frozen plasma in the cirrhosis group was obviously less than that in the hepatic failure group, but the infusion of platelet in the cirrhosis group was significantly more than that in the liver cancer group. The infusion of red blood cells from July 2013 to June 2015 was significantly less than that from July 2012 to June 2013. The blood loss, infusion of red blood cells and frozen plasma in the liver transplantation group of cirrhosis were significantly more than those in the abdominal multiple organ transplantation group of cirrhosis （all P 〈 0.05）. In conclusion, diagnosis of liver diseases, and the maturity of surgery exert an effect on the blood loss and blood infusion. As the development of liver transplantation and abdominal multiple organ transplantation, both the blood lo

关 键 词：肝移植 器官移植 失血 手术 输血 组织构建 组织工程 腹部多器官移植 失血 红细胞输注量 血小板输注量 冷沉淀输注量 血浆输注量 肝癌 肝硬化 存活期 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]