肾移植患者术中用血与实验室检测结果、排异反应及术后感染的相关性分析  

Correlation analysis of perioperative blood transfusion with laboratory testing results,rejection,and post-transplant infection in patients with renal transplantation

作　　者：程俊晓 孟祥红[1] 李刚[2] 钱叶勇[2] 孙东旭 CHENG Junxiao;MENG Xianghong;LI Gang;QIAN Yeyong;SUN Dongxu(Department of Clinical Transfusion,Chinese PLA General Hospital,Beijing 100091,China;Department of Transplant Surgery the Eighth Medical Center,Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心输血科,北京100091 [2]解放军总医院第八医学中心移植外科,北京100091

出　　处：《解放军医学院学报》2020年第9期857-859,875,共4页Academic Journal of Chinese PLA Medical School

基　　金：北京市科委首都临床特色专项课题(Z161100000516180)。

摘　　要：目的研究分析肾移植患者术中用血情况和患者实验室检测指标,为临床肾移植术用血策略提供依据。方法回顾性分析我中心2014-2015年258例肾移植手术患者用血情况,并比较分析肾移植术中用血与未用血患者院内感染和排异反应情况。结果 258例肾移植患者中有94例术中用血,用血率为36.4%;用血与未用血肾移植患者术前血红蛋白、血细胞比容和凝血酶原活动度差异有统计学意义(P<0.05)。94例术中用血患者术后排斥反应发生率为9.57%(9/94),164例未用血患者术后排斥反应发生率为9.15%(15/164),差异无统计学意义(P>0.05);94例术中用血患者院内感染发生率为6.38%(6/94),显著高于164例未用血患者的院内感染发生率(1.22%,2/164)(P<0.05)。结论应在肾移植术前积极对受者进行抗贫血治疗及出凝血管理,减少不必要的输血,加强肾移植术中用血管理。输血与移植后排斥反应、感染的关系还需要进一步研究。Objective To study the situation of perioperative blood transfusion in patients with renal transplantation and analyze the laboratory indexes of patients,and provide evidences for clinical blood transfusion strategy of renal transplantation.Methods The blood transfusion data of 258 patients with renal transplantation in our hospital from 2014 to 2015 were retrospectively analyzed;the laboratory indexes,and the rates of nosocomial infection and rejection in patients with blood transfusion and without blood transfusion were analyzed comparatively.Results Among the 258 patients with renal transplantation,94 patients had taken blood transfusion with the blood transfusion rate of 36.4%.There were significant differences in hemoglobin,hematocrit and activated partial thrombin time between patients with blood transfusion and without blood transfusion (P<0.05,respectively).The incidence of rejection of patients with blood transfusion and without blood transfusion were 9.57% (9/94) and 9.15% (15/164),and the difference was not statistically significant (P>0.05).The incidence of nosocomial infection of patients with blood transfusion and without blood transfusion were 6.38% (6/94) and 1.22% (2/164),respectively (P<0.05).Conclusion Anemia treatment and coagulation management should be taken actively before transplantation to lessen unnecessary blood transfusion,and perioperative blood transfusion management should be strengthened.The relationship of blood transfusion with rejection and nosocomial infection needs further study.

关 键 词：肾移植 用血 贫血 感染 排异反应 

分 类 号：R69[医药卫生—泌尿科学]