减少肝移植围手术期输血相关策略的研究进展  

Research progress on strategies of reducing perioperative blood transfusion in liver transplantation

作　　者：张骊[1] 杨健[1] 蒋文涛[1] Zhang Li;Yang Jian;Jiang Wentao(Department of Liver Transplantation,Tianjin First Center Hospital,Key Laboratory of Critical Care Emergency Medicine of National Health Commission of China,Key Laboratory of Organ Transplantation in Tianjin,Key Laboratory of Transplantation Medicine of Chinese Academy of Medical Science,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院肝移植科,国家卫生健康委员会危重病急救医学重点实验室,天津市器官移植重点实验室,中国医学科学院移植医学重点实验室,300192

出　　处：《器官移植》2021年第1期115-119,共5页Organ Transplantation

基　　金：国家自然科学基金(81870444);天津市自然科学基金(17JCQNJC12800、20JCYBJC01010);天津市第一中心医院春蕾计划(CL201801)。

摘　　要：肝移植手术一直存在大量失血和输血的问题。在过去的二十年中,随着肝移植技术的不断成熟,围手术期输血量急剧减少,无输血肝移植成为现实。由于出血和输血都与肝移植的不良预后相关,减少出血和不必要的输血成为了肝移植围手术期的关键目标。本文总结了肝移植围手术期异体输血的不良影响、终末期肝病患者的凝血功能监测、肝移植受者的输血管理以及减少肝移植围手术期输血的策略,旨在为减少肝移植围手术期的输血需求提供参考。Massive blood loss and blood transfusion constantly occur in liver transplantation.Over the past two decades,the amount of blood transfusion during the perioperative period has been decreased dramatically along with the continual maturity of liver transplantation techniques.The goal of liver transplantation without blood transfusion has been achieved.Since bleeding and blood transfusion are correlated with poor prognosis after liver transplantation,reducing bleeding and unnecessary blood transfusion has become the key objective during perioperative period of liver transplantation.In this article,adverse effects of allogeneic blood transfusion during perioperative period of liver transplantation,coagulation function monitoring of patients with end-stage liver disease,blood transfusion management of liver transplant recipients and the strategies of reducing perioperative blood transfusion in liver transplantation were summarized,aiming to provide reference for reducing the requirement of blood transfusion during perioperative period of liver transplantation.

关 键 词：肝移植 输血 患者输血管理 凝血酶原时间国际标准化比值 粘弹性凝血功能监测 异体输血 促红细胞生成素 中心静脉压 

分 类 号：R617[医药卫生—外科学]