湖北省胃肠道肿瘤患者围手术期贫血诊治现状的多中心调查报告  

Diagnosis and treatment status of perioperative anemia in patients with gastrointestinal neoplasms:a multi-center study in Hubei Province

作　　者：张鹏[1] 江从庆[2] 熊治国[3] 郑勇斌[4] 付应峰 李新明 庞典付[7] 廖晓锋[8] 童昕 朱焕明[9] 杨振华[10] 龚光伟 尹小平[12] 李栋梁 李红军[14] 陈洪流 蒋雪峰[16] 何志军 陆艳军[18] 帅晓明[1] 高金波[1] 蔡开琳 陶凯雄[1] Peng Zhang;Congqing Jiang;Xiong Zhiguo;Zheng Yongbin;Fu Yingfeng;Li Xinming;Pang Dianfu;Liao Xiaofeng;Tong Xin;Zhu Huanming;Yang Zhenhua;Gong Guangwei;Yin Xiaoping;Li Dongliang;Li Hongjun;Chen Hongliu;Jiang Xuefeng;He Zhijun;Lu Yanjun;Shuai Xiaoming;Gao Jinbo;Cai Kailin;Tao Kaixiong(Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Colorectal and Anal Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;DepartmentⅠof Gastrointestinal Surgery,Hubei Cancer Hospital,Wuhan 430079,China;Department of Gastrointestinal and Anorectal Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Gastrointestinal Surgery,Taihe Hospital,Hubei University of Medicine,Shiyan 442000,China;Department of Gastrointestinal and Anorectal Surgery,Central Hospital of Edong Healthcare Group,Hubei Polytechnic University,Huangshi 435000,China;Department of Gastrointestinal Surgery,Jingzhou Central Hospital,Jingzhou 434020,China;Department of General Surgery,Xiangyang Central Hospital,Hubei College of Liberal Arts and Sciences,Xiangyang 441021,China;Department of Gastrointestinal Surgery,People′s Hospital of Macheng,Huanggang 438300,China;Department of Gastiointestinal Surgery,Institute of Digestive Disease,China Three Gorges University,Yichang Central People's Hospital,Yichang 443000,China;Department of Gastrointestinal Surgery,Xiaogan Hospital of Wuhan University of Science and Technology,Xiaogan 432600,China;Department of Gastrointestinal SurgeryⅡWard,Xianning Central Hospital,Hubei University of Science and Technology,Xianning 437100,China;Department of Gastrointestinal Surgery,Xishui People′s Hospital,Huanggang 438200,China;Department of General Surgery,the First People′s Hospital of Zaoyang,Xiangyang 441200,China;Department of General Surgery,Affiliated Hospital of Hubei Institute for Nationalities,Enshi 445000,China;Department of Gastrointestinal Surgery,the First People′s Hospital of Jing

机构地区：[1]华中科技大学同济医学院附属协和医院胃肠外科,武汉430022 [2]武汉大学中南医院结直肠肛门外科,武汉430071 [3]湖北省肿瘤医院胃肠外科,武汉430079 [4]武汉大学人民医院胃肠外Ⅰ科,武汉430060 [5]十堰市太和医院湖北医药学院附属医院胃肠外科,十堰442000 [6]鄂东医疗集团市中心医院湖北理工学院附属医院胃肠肛肠外科,黄石435000 [7]荆州市中心医院胃肠外科,荆州434020 [8]襄阳市中心医院湖北文理学院附属医院普外科,襄阳441021 [9]麻城市人民医院胃肠外科,黄冈438300 [10]三峡大学消化疾病研究所,宜昌市中心人民医院胃肠外科,宜昌443000 [11]武汉科技大学附属孝感医院胃肠外科,孝感432600 [12]咸宁市中心医院,湖北科技学院附属第一医院胃肠外科Ⅱ病区,咸宁437100 [13]浠水县人民医院胃肠外科,黄冈438200 [14]枣阳市第一人民医院普外科,襄阳441200 [15]湖北民族大学附属民大医院普外科,恩施445000 [16]荆州市第一人民医院胃肠外科,荆州434000 [17]湖北医药学院附属人民医院胃肠外科,十堰442000 [18]黄冈市中心医院胃肠外科,黄冈438000

出　　处：《中华外科杂志》2022年第1期32-38,共7页Chinese Journal of Surgery

基　　金：国家自然科学基金(81702386,81874184,82072736)。

摘　　要：目的了解湖北省胃肠道肿瘤患者围手术期贫血发生率及治疗现状。方法采用网络数据库形式收集2019年湖北省15个市(州)62家医院7474例接受手术治疗的胃肠道肿瘤患者的临床病理学资料。男性4749例,女性2725例,中位年龄62岁(范围:17~96岁)。根据患者入院第1次和术后第1天的血红蛋白值判断患者是否存在术前和术后贫血,90~<120 g/L(男性)或90~<110 g/L(女性)为轻度贫血,60~<90 g/L为中度贫血,<60 g/L为重度贫血。采用t检验或χ^(2)检验进行组间比较。结果全部患者术前贫血发生率为38.60%(2885/7474),术后贫血发生率为61.40%(4589/7474)。术前贫血患者中接受治疗的比例为26.86%(775/2885),术后贫血患者中接受治疗的比例为14.93%(685/4589)。三级甲等、三级乙等、二级甲等医院术前贫血患者中接受治疗的比例分别为26.12%(649/2485)、32.32%(85/263)、29.93%(41/137),术后贫血患者中接受治疗的比例分别为14.61%(592/4052)、22.05%(73/331)、9.71%(20/206)。术前贫血组患者术中输血比例[16.74%(483/2885)比3.05%(140/4589),χ^(2)=434.555,P<0.01]和术后并发症发生率[17.78%(513/2885)比14.08%(646/4589),χ^(2)=18.553,P<0.01]高于非贫血组,术前贫血组患者术后住院时间长于非贫血组[(14.1±7.3)d比(13.3±6.2)d,t=5.202,P<0.01]。结论胃肠道肿瘤患者围手术期贫血发生率较高,术前贫血可增加患者术中输血需求并影响短期预后。目前湖北省胃肠外科医师的围手术期贫血规范化治疗理念有待提高。Objective To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province.Methods The clinicopathological data of 7474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities(state)of Hubei Province in 2019 were collected in the form of network database.There were 4749 males and 2725 females.The median age of the patients was 62 years(range:17 to 96 years).The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia.Anemia was defined as male hemoglobin<120 g/L and female hemoglobin<110.0 g/L,mild anemia as 90 to normal,moderate anemia as 60 to<90 g/L,severe anemia as<60 g/L.The t test andχ^(2) test were used for inter-group comparison.Results The overall incidence of preoperative anemia was 38.60%(2885/7474),and the incidences of mild anemia,moderate anemia and severe anemia were 25.09%(1875/7474),11.37%(850/7474)and 2.14%(160/7474),respectively.The overall incidence of postoperative anemia was 61.40%(4589/7474).The incidence of mild anemia,moderate anemia and severe anemia were 48.73%(3642/7474),12.20%(912/7474)and 0.47%(35/7474),respectively.The proportion of preoperative anemia patients receiving treatment was 26.86%(775/2885),and the proportion of postoperative anemia patients receiving treatment was 14.93%(685/4589).The proportions of preoperative anemia patients in gradeⅢA,gradeⅢB,and gradeⅡA hospitals receiving treatment were 26.12%(649/2485),32.32%(85/263),and 29.93%(41/137),and the proportions of postoperative anemia patients receiving treatment were 14.61%(592/4052),22.05%(73/331),and 9.71%(20/206).The proportion of intraoperative blood transfusion(16.74%(483/2885)vs.3.05%(140/4589),χ^(2)=434.555,P<0.01)and the incidence of postoperative complications(17.78%(513/2885)vs.14.08%(646/4589),χ^(2)=18.553,P<0.01)in the preoperative anemia group were higher than those in the non-anemia group,and the postoperative hospital stay

关 键 词：胃肠肿瘤 贫血 围手术期医护 

分 类 号：R735[医药卫生—肿瘤]