肝血管瘤术中自体血回输51例临床分析  

Clinical analysis of 51 cases of intraoperative autotransfusion of hepatic hemangioma

作　　者：鞠明光 徐锋[1] 贾昌俊[1] 赵阳[1] 彭松林[1] 张荷月 刘阳[2] 戴朝六[1] Ju Mingguang;Xu Feng;Jia Changjun;Zhao Yang;Peng Songlin;Zhang Heyue;Liu Yang;Dai Chaoliu(Department of Hepatobiliary and Splenic Surgery,Shengjing Hospital of China Medical University,Liaoning Shenyang 110004,China;Operating Room,Shengjing Hospital of China Medical University,Liaoning Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院肝胆脾外科,辽宁沈阳110004 [2]中国医科大学附属盛京医院手术室,辽宁沈阳110004

出　　处：《腹部外科》2019年第6期413-416,共4页Journal of Abdominal Surgery

基　　金：辽宁省科学技术计划项目(2017225032)

摘　　要：目的探讨肝血管瘤术中应用自体血回输技术的优势、存在的问题和应用指征。方法纳入中国医科大学附属盛京医院2014年4月至2018年10月接受手术治疗且术中应用自体血回输的肝血管瘤病人的临床资料,根据肿瘤位置、肿瘤直径将51例病例资料分为"简单组"和"复杂组"。分析病人围手术期指标和术后并发症。结果两组病人性别、年龄、肿瘤数量、肝门阻断情况及手术方式差异无统计学意义(P>0.05),但"复杂组"肿瘤直径大于"简单组"(P=0.035)。"复杂组"的手术时间、失血量和回输血量均高于"简单组"(P<0.05)。"简单组"和"复杂组"中分别有1例和5例额外输入异体血,但二者差异无统计学意义(P>0.05);两组病人术后胃肠道功能恢复时间、留置引流管时间、术后住院时间差异均无统计学意义(均P>0.05);术后并发症主要包括盆腹腔积液、胸腔积液、肺不张、胆汁漏和术后腹腔内出血,两组差异均无统计学意义(均P>0.05)。"复杂组"中未输异体血的病例术后血常规及凝血功能指标均无较大波动,可在短期内恢复正常。所有病人围手术期未见过敏、溶血、发热等输血相关不良反应。结论肝血管瘤术中应用自体血回输疗效可靠且安全,有一定经济效益。位于肝4a段、6段、7段和尾状叶的肿瘤,以及位于肝左外叶、4b段、5段和8段且瘤体≥10 cm的肿瘤更符合应用指征。Objective To investigate the advantages,problems and indications of autologous blood transfusion in the operation of hepatic hemangioma.Methods The clinical data of 51 patients with hepatic hemangioma who received surgical treatment and received intraoperative autologous blood transfusion from April 2014 to October 2018 in our hospital were included.According to the tumor location and tumor diameter,51 cases were divided into"simple group"and"complex group".The perioperative indexes and postoperative complications were analyzed.Results There was no significant difference in sex,age,tumor number,hepatic portal occlusion and surgery manner between the two groups(P>0.05),but the tumor diameter in the"complex group"was larger than that in the"simple group"(P=0.035).The operation time,blood loss and blood transfusion volume in the"complex group"were higher than those in the"simple group"(P<0.05).In the"simple group"and"complex group",1 and 5 cases were additionally transfused with allogeneic blood,respectively,but there was no significant difference between the two groups(P>0.05).There was no significant difference in postoperative gastrointestinal function recovery time,indwelling drainage tube time and postoperative hospital stay between the two groups(P>0.05).There was no significant difference in the main postoperative complications included pelvic and abdominal effusion,pleural effusion,atelectasis,bile leakage and postoperative intraperitoneal hemorrhage(P>0.05).In the"complex group",the blood routine and coagulation function of the patients without allogeneic blood transfusion did not fluctuate greatly after operation,and could return to normal during a short time.No transfusion related adverse reactions such as allergy,hemolysis and fever were found in all patients during the perioperative period.Conclusion Autologous blood transfusion is effective and safe in the operation of hepatic hemangioma,and it has certain economic benefits.Tumors located in segment 4 a,segment 6,segment 7 and caudate lobe,as well as t

关 键 词：肝血管瘤 回收式自体输血 

分 类 号：R619.9[医药卫生—外科学]