腹膜假黏液瘤术中大量输血风险因素分析  

Analysis on the risk factors of massive blood transfusion during pseudomyxoma peritonei surgery

作　　者：陆良愿 李寒阳 杨占民[1] LU Liangynan;LI Hanyang;YANG Zhanmin(Anesthesiology Department Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院麻醉科

出　　处：《中国输血杂志》2019年第11期1133-1136,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨腹膜假黏液瘤患者围术期因素对术中大量输血的影响。方法选取我院粘液瘤中心2018年3-12月术前明确诊断腹膜假粘液瘤,择期在静吸复合全身麻醉下行腹膜假粘液瘤减瘤+术中腹腔热灌注化疗手术患者130例。所有患者分为大量输血组和对照组,收集患者围术期因素(年龄、BMI、术前血红蛋白、血小板、白蛋白、谷丙转氨酶、血清肌酐水平、纤维蛋白原、术前/术后腹膜癌指数、减瘤指数、手术时间),采用单因素分析及logistic回归方法,对术前因素与术中大量输血之间的关系进行分析。结果单因素分析结果显示,体重指数、术前白蛋白水平、纤维蛋白原、术前/术后腹膜癌指数、减瘤指数与术中大量出血有关系(P<0.05)。多因素回归分析结果中术前血红蛋白水平、体重指数及纤维蛋白原含量对术中大量输血具有影响(P<0.05)。结论术前纠正贫血,提高患者体重指数有利于减少术中大量输血。Objective To analyze the relationship between perioperative factors and massive intraoperative blood transfusion in patients with pseudomyxoma peritonei(PMP).Methods A total of 130 patients diagnosed with PMP were selected to conduct with CRS/HIPEC surgery under intravenous aspiration combined with general anesthesia during March to December in 2018.All patients were divided into massive blood transfusion group and control group.The relationship between perioperative factors(including age,body mass index,preoperative hemoglobin,platelet,albumin,alanine aminotransferase,creatinine,fibrinogen,preoperative/postoperative peritoneal cancer index,tumor reduction index,and operative time etc.)and massive blood transfusion were analyzed in univariate and multivariate regression.Results Univariate analysis results showed that the body mass index,preoperative albumin level,fibrinogen,preoperative/postoperative peritoneal cancer index and tumor reduction index were associated with intraoperative massive blood transfusion(P<0.05).The results of multivariate analysis demonstrated that the preoperative hemoglobin level,body mass index and fibrinogen were affected by intraoperative massive blood transfusion significantly(P<0.05).Conclusion Preoperative remediation of anemia and improvement of body mass index can decrease intraoperative massive blood transfusion.

关 键 词：腹膜假黏液瘤 大量输血 LOGISTIC回归分析 

分 类 号：R457.1[医药卫生—治疗学] R656.41[医药卫生—临床医学]