肝胆疾病患者术前贫血状况调查  

Investigation and analysis of preoperative anemia in patients with hepatobiliary diseases

作　　者：罗圆圆[1] 林洁[1] 蔡晓瑜 刘俊婷 王淑芳[1] 关晓珍[1] 汪德清[1] LUO Yuanyuan;Lin Jie;Cai Xiaoyu;Liu Junting;Wang Shufang;Guan Xiaozhen;WANG Deqing(Department of Transfusion,PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院输血科,北京100853

出　　处：《中国输血杂志》2020年第2期102-106,共5页Chinese Journal of Blood Transfusion

基　　金：白求恩公益基金会课题(BQE-2018-SX-01);战创伤凝血制品冷沉淀制备条件优化研究课题(2018FC-WJFWZX-1-18)。

摘　　要：目的了解肝胆疾病患者术前贫血的发生率,并对相关因素进行分析。方法回顾性分析2014年1月-2019年1月本院肝胆科27 056例手术患者,提取患者基本信息及相关检测指标,统计分析相关因素与术前贫血的关系。结果肝胆疾病患者女性术前贫血率高于男性,在各民族中回族术前贫血率(41.22%)相对较高,老年人术前贫血率(58.44%)、农民术前贫血率(37.43%)最高(P<0.05),各血型间术前贫血率差异较小;随着体重指数的增加术前贫血率降低,BMI<18.5的患者贫血率最高为59.44%;WBC、Plt、ALB、ALT、PT、APTT异常,术前贫血率(53.21%、46.11%、69.24%、43.22%、35.87%、34.76%)均升高(P<0.05);术前贫血患者住院天数>15 d的比例(轻度贫血:47.05%,中、重度贫血:58.95%)均高于血红蛋白正常患者,中、重度贫血患者住院天数>21 d的比例(39.16%)最高;肝胆疾病患者术前中、重度贫血较轻度贫血少,主要为正细胞性贫血;Logistic回归分析显示,性别、年龄、BMI、WBC、Plt、ALB、ALT、PT、APTT和术前贫血之间有统计学差异(P<0.05)。术前贫血患者围术期红细胞、血浆和血小板的输血比例(34.32%、24.42%、2.62%)和人均输血量(6.63 U、6.38 U、1.87 U)均高于血红蛋白正常患者,术前药物干预较少。结论肝胆疾病患者术前贫血率较高,影响因素较多,应积极治疗贫血、提前干预,降低术中输血率、减少住院天数。Objective To determine the prevalence of preoperative anemia in patients with hepatobiliary diseases and to analyze related factors.Methods A retrospective analysis of 27056 surgical patients from the Department of Hepatobiliary in PLAgeneral hospital from January 2014 to January 2019 was conducted. The basic information and related detection indicators were extracted, and the relationship between related factors and preoperative anemia was statistically analyzed. Results The prevalence of preoperative anemia in women with hepatobiliary diseases was higher than that in men. The prevalence of preoperative anemia inHui nationality(41.22%)was relatively high among all ethnic groups. And patients in 80-99 age range(58.44%) and farmers(37.43%) had the highest prevalence in age groups and occupation groups, respectively.Marginal difference in preoperative anemic prevalence was observed among blood types.The prevalence of preoperative anemia decreased with body mass index(BMI), and patients in BMI<18.5 range had the highest one(59.44%).The prevalence of preoperative anemia in patients with abnormal clinical indicators, such as WBC, Plt, ALB, ALT, PT and APTT(53.21%, 46.11%, 69.24%, 43.22%, 35.87% and 34.76%) was significantly higher than those with normal indicators(P<0.05).The proportion of hospitalized patients involving>15-day hospital stay(47.05% in mild anemia and 58.95% in moderate to severe anemia) was higher than that of patients with normal Hb concentration;the proportion of hospitalized patients involving >21-day hospital stay was the highest in patients with moderate to severe anemia(39.16%). Patients with hepatobiliary disease had less moderate to severe anemia than mild anemia before surgery, with normocytic anemia as the dominant.Logistic regression analysis showed that there were statistically significant differences between gender, age, BMI, WBC, Plt, ALB, ALT, PT, APTT and preoperative anemia(P<0.05).The proportion of patients requiring erythrocyte, plasma and platelet transfusion(34.32%, 24.42% and 2.6

关 键 词：术前贫血 输血 肝胆疾病 手术 

分 类 号：R457.1[医药卫生—治疗学] R657.3[医药卫生—临床医学]