脊柱侧弯儿童和青少年患者后路矫形术中异体悬浮红细胞输注量的影响因素分析  

Influencing factors of allogeneic suspended red blood cells transfusion volume during posterior orthopedic surgery in children and adolescents with scoliosis

作　　者：郁金凤 刘婷婷 李平[1] 陆乐[1] Yu Jinfeng;Liu Tingting;Li Ping;Lu Le(Department of Blood Transfusion,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属鼓楼医院输血科,210008

出　　处：《国际输血及血液学杂志》2021年第3期241-246,共6页International Journal of Blood Transfusion and Hematology

基　　金：南京市科技发展计划项目 (201715018)。

摘　　要：目的探讨儿童和青少年脊柱侧弯患者后路矫形术中,异体悬浮红细胞(ASRBC)输注量的影响因素。方法选择2018年1月至12月,于南京大学医学院附属鼓楼医院行后路矫形术的437例脊柱侧弯儿童和青少年患者为研究对象。其中,男性患者为154例,年龄为(12.2±4.5)岁;女性为283例,年龄为(12.8±3.9)岁。按照患者术中ASRBC输注量,将其分为ASRBC>3 U组(n=160)和ASRBC≤3 U组(n=277)。采用回顾性研究方法,收集2组患者的脊柱侧弯类型、病程、手术时间、术中出血量,以及术中ASRBC、异体血浆、冷沉淀、血小板输注量等临床病例资料。以上临床资料的组间比较,根据资料类型选择采用独立样本t检验、Mann-Whitney U检验或者χ^(2)检验。根据单因素分析结果,以及既往研究结果和临床经验,将脊柱侧弯儿童和青少年患者后路矫形术中ASRBC输注量的影响因素纳入非条件多因素logistic回归分析。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求,并且与所有受试者或监护人签署临床研究知情同意书。结果①本研究437例儿童和青少年脊柱侧弯患者后路矫形术中ASRBC输注量为(3.24±1.90)U。ASRBC>3 U组患者的术中总输血量、ASRBC输注量,以及异体血浆、冷沉淀、血小板输注率,分别为1300 mL(993~1850 mL)、(5.3±1.7)U、51.3%(82/160)、30.6%(49/160)、4.4%(7/160),分别显著高于ASRBC≤3 U组的550 mL(310~750 mL)、(2.1±0.7)U、7.2%(20/277)、1.4%(4/277)、0.4%(1/277),并且差异均有统计学意义(Z=14.0、P<0.001,t=112.5、P<0.001,χ^(2)=109.9、P<0.001,χ^(2)=81.0、P<0.001,χ^(2)=9.1、P=0.004)。②单因素分析结果显示,2组脊柱侧弯儿童和青少年患者的年龄、脊柱侧弯类型构成比、病程、手术时间、术中出血量分别比较,差异均有统计学意义(t=17.9、P<0.001,χ^(2)=8.7、P=0.013,Z=5.1、P<0.001,t=12.5、P<0.001,Z=12.6、P<0.001)。③非条件多因素logistic回归分析结果显Objective To explore the influencing factors of allogeneic suspended red blood cells(ASRBC)transfusion volume during posterior orthopedic surgery in children and adolescents with scoliosis.Methods From January to December 2018,a total of 437 children and adolescents who underwent posterior orthopedic surgery for correction of scoliosis in Nanjing Drum Tower Hospital were selected as research subjects.There were 154 male patients with age of(12.2±4.5)years,and 283 females with age of(12.8±3.9)years.The patients were divided into two groups according to volume of ASRBC transfused during posterior orthopedic surgery:ASRBC>3 U group(n=160)and ASRBC≤3 U group(n=277).The clinical data,such as scoliosis type,duration of disease,operation time,intraoperative blood loss,as well as transfusion volumes of ASRBC,allogeneic plasma,allogeneic cryoprecipitate and allogeneic platelet during surgery were collected retrospectively.Independent samples t test of Mann-Whitney U test,Chi-square test were used to compare the above clinical data between two groups.According to results of univariate analysis,as well as results of previous research and clinical experience,influencing factors of ASRBC transfusion volume during posterior orthopedic surgery in children and adolescents with scoliosis were included in unconditional multivariate logistic regression analysis.The procedures followed in this study were in accordance with the requirements of the Declaration of Helsinki of the World Medical Association revised in 2013,and informed consent for clinical research was signed by all subjects or their guardians.Results①In this study,ASRBC transfusion volume during surgery of 437 children and adolescents with scoliosis were(3.24±1.90)U.The transfusion volume of total blood and ASRBC,as well as the transfusion rate of allogeneic plasma,allogeneic cryoprecipitate and allogeneic platelet during surgery were 1300 mL(993-1850 mL),(5.3±1.7)U,51.3%(82/160),30.6%(49/160)and 4.4%(7/160)in ASRBC>3 U group,which were higher than those of 550

关 键 词：脊柱侧凸 矫形外科手术 输血 红细胞输注 危险因素 脊柱侧凸 特发性 青少年 儿童 

分 类 号：R726.8[医药卫生—儿科]