肝胆胰外科手术单病种临床用血分析  

Clinical blood transfusion analysis of single disease in hepatobiliary and pancreatic surgery

作　　者：赵晓明[1] 朱驰 于思远 杨冀 吴文娟[1] ZHAO Xiaoming;ZHU Chi;YU Siyuan;YANG Ji;WU Wenjuan(Department of Laboratory Medicine,South Hospital Affiliated to Shanghai East Hospital,Tongji University School of Medicine,Shanghai,200120,China)

机构地区：[1]同济大学附属上海市东方医院南院检验科,上海200120

出　　处：《临床血液学杂志（输血与检验）》2020年第6期840-844,共5页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：上海市浦东新区卫生系统重点学科建设资助(No:PWZxk2017-09)。

摘　　要：目的:以肝胆胰外科的单病种择期手术患者为研究对象,分析探讨术中用血的患者的输血方式及各成分血临床用血量间的差异,为输血科合理备血、提升肝胆胰外科单病种临床用血及手术水平提供有价值的参考信息。方法:搜集2016-01-01—2018-12-31进行肝胆胰外科手术,术中用血的151例患者临床输血资料,分析其年龄、病种、血型的分布情况,并对其输血方式和各种异体成分血的输注情况进行回顾性的统计分析。结果:151例手术患者病种多为肝癌及胰腺癌。有29例术中应用了自体输血技术,其中,13例为自体异体联合输血患者,其余16例仅应用自体输血。不同病种的胆胰外科手术患者间年龄分布差异无统计学意义;不同病种、血型间悬浮红细胞、冰冻血浆的平均用血量差异无统计学意义,但冷沉淀凝血因子的平均用血量差异有统计学意义。脾功能亢进患者与胰腺癌患者的悬浮红细胞用量差异有统计学意义,肝硬化患者与胆管癌、肝癌患者的冷沉淀凝血因子用量差异有统计学意义。单纯自体输血患者与单纯异体输血患者年龄比较差异有统计学意义,异体自体联合输血患者与单纯自体输血患者、单纯异体输血患者间比较差异无统计学意义。结论:通过对肝胆胰外科单病种手术患者术中输血情况的分析,总结出各病种的备血经验,有利于输血科制定该科室各个病种手术患者的储血计划;自体输血是肝胆胰外科手术重要的血液保护措施,可有效节约宝贵的血液资源。Objective:To analyze and discuss the difference of blood transfusion mode and the amount of blood of various components in the patients of hepatobiliary and pancreatic surgery of single disease in our hospital,so as to provide valuable reference information for the reasonable preparation of blood and improve the clinical blood use and operation level of single diseases in hepatobiliary and pancreatic surgery. Method:The clinical blood transfusion data of 151 patients in hepatobiliary and pancreatic surgery from January 1,2016 to December 31,2018 were collected,the distribution of age,disease type and blood type were analyzed,and the blood transfusion mode and the blood transfusion of various allogeneic components were analyzed retrospectively. Result:Most of the 151 patients who received intraoperative blood transfusion were hepatocarcinoma and pancreatic cancer.29 cases used autologous transfusion,among which 13 cases were combined autotransfusion,the other 16 cases only used autotransfusion.There was no significant difference in the age distribution among the patients with different diseases,and there was no significant difference in the mean blood consumption of suspended red blood cells and frozen plasma between different diseases and blood groups,but there was significant difference in the mean blood consumption of cold precipitated coagulation factors.There was a significant difference in the dosage of suspended erythrocytes between the patients with hypersplenism and those with pancreatic cancer,and in the dosage of cold precipitated coagulation factor between the patients with cirrhosis and those with cholangiocarcinoma and hepatocarcinoma.There was no significant difference in age between patients with autotransfusion alone and patients with allogeneic transfusion alone.Conclusion:Based on the analysis of blood transfusion during the operation of single disease in hepatobiliary and pancreatic surgery in our hospital,the experience of blood preparation for each disease is summarized,which may be helpful f

关 键 词：肝胆胰外科手术 单病种 自体输血 临床用血量 

分 类 号：R457.1[医药卫生—治疗学]