主动脉夹层患者术前贫血对术中输血及预后的影响  

Effect of Preoperative Anemia on Intraoperative Blood Transfusion and Prognosis in Patients with Aortic Dissection

作　　者：刘帅[1] 王丽丽 任洁 郭晓燕 康丽霞[2] 张晨光 LIU Shuai;WANG Lili;REN Jie;GUO Xiaoyan;KANG Lixia;ZHANG Chenguang(Department of Blood Transfusion,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,China;Department of Clinical Laboratory,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,China;School of Medical Laboratory,Xinxiang Medical University,Xinxiang 453003,China)

机构地区：[1]新乡医学院第三附属医院输血科,河南新乡453003 [2]新乡医学院第三附属医院检验科,河南新乡453003 [3]新乡医学院医学检验学院,河南新乡453003

出　　处：《河南医学研究》2021年第27期5010-5013,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(201602158)。

摘　　要：目的探讨主动脉夹层患者术前贫血对术中输血及预后的影响。方法回顾分析104例Ⅰ型主动脉夹层患者的病例资料。根据患者术前血红蛋白水平,将患者分为贫血组(42例)和非贫血组(62例),分析术前贫血对两组患者术中输血及预后的影响,通过多因素logistic回归分析术前贫血是否为术中输血和术后住院死亡的独立影响因素。结果贫血组术中输血风险高于非贫血组(OR=4.056,P<0.05);贫血组术中悬浮红细胞、冰冻血浆、冷沉淀、血小板的输注量均高于非贫血组(P<0.05);贫血组术后住院死亡风险高于非贫血组(OR=5.744,P<0.001)。多因素logistic回归分析结果显示,术前贫血是术中输血和术后住院死亡的危险因素(P<0.05),术前血红蛋白水平是术中输血和术后住院死亡的保护因素(P<0.05),术前血红蛋白水平每增加1 g·L^(-1),术中输血风险降低3.5%,术后住院死亡风险降低3.2%。结论主动脉夹层患者术前贫血能增加术中输血风险和输血量以及术后住院死亡风险,做好主动脉夹层患者术前贫血管理,以最佳方法优化术前血红蛋白水平,可以降低术中输血风险和术后住院死亡风险。Objective To investigate the effect of preoperative anemia on intraoperative blood transfusion and prognosis in patients with aortic dissection.Methods The case data of 104 patients with typeⅠaortic dissection were retrospectively reviewed.According to the preoperative hemoglobin level,the patients were divided into anemia group(42 cases)and non-anemia group(62 cases).The effect of preoperative anemia on intraoperative blood transfusion and prognosis of the two groups were analyzed,whilst multivariate logistic regression analysis was used to determine whether preoperative anemia was an independent risk factor for intraoperative blood transfusion and postoperative in-hospital mortality.Results Compared with the non-anemia group,the anemia group had a higher risk of intraoperative blood transfusion(OR=4.056,P<0.05).The volume of blood transfusion(red blood cell,plasma,cryoprecipitate,platelet)in anemia group was higher than that in non-anemia group(P<0.05).The risk of in-hospital mortality in anemia group was higher than that in non-anemia group(OR=5.744,P<0.001).Multivariate logistic regression analysis showed that preoperative anemia was a risk factor for intraoperative blood transfusion and postoperative in-hospital mortality(P<0.05),however,preoperative hemoglobin level was a protective factor(P<0.05).With every 1 g·L^(-1) increase in preoperative hemoglobin level,the risk of intraoperative blood transfusion decreased by 3.5%and postoperative in-hospital mortality was decreased by 3.2%.Conclusion Preoperative anemia in patients with aortic dissection can increase the risk of intraoperative blood transfusion and transfusion volume,as well as the risk of postoperative in-hospital mortality.The management of preoperative anemia and optimization of preoperative hemoglobin level in patients with aortic dissection can reduce the risk of intraoperative blood transfusion and postoperative in-hospital mortality.

关 键 词：术前贫血 主动脉夹层 术中输血 预后 术前血红蛋白 

分 类 号：R543.1[医药卫生—心血管疾病]