原发性恶性骨肉瘤术中输血影响因素的回顾性研究  

Influencing factors of intraoperative blood transfusion in primary malignant osteosarcoma:a retrospective study

作　　者：王默然 王峻 李星晨[1] 刘浩 葛艳玲[1] WANG Moran;WANG Jun;LI Xingchen;LIU Hao;GE Yanling(Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院输血科,北京100035

出　　处：《中国输血杂志》2022年第1期35-38,共4页Chinese Journal of Blood Transfusion

摘　　要：目的本研究旨在术前确定与原发恶性骨肉瘤手术患者术中输血相关的高危影响因素,为新冠肺炎疫情持续存在期间如何科学合理制定骨肉瘤术前备血计划提供参考依据。方法回顾性分析北京积水潭医院2020年1月~2021年1月骨肿瘤科原发恶性骨肉瘤手术患者的病例资料120份,收集患者的一般资料、术前血常规及凝血资料、临床病理资料及手术相关资料,通过单因素分析、多因素回归分析确定原发恶性骨肉瘤患者术中输血的高危险因素。结果1)原发恶性骨肉瘤患者术中输血率为48.33%(58/120),平均输血量为(1.36±1.14)U;术后输血率为62.50%(75/120),平均输血量为(2.93±2.26)U;2)单因素分析:性别、术前Hct、术前Plt、病变位置、Huvos分级、切口长度、重建长度及术中出血量等因素,P<0.05;3)多因素Logistic回归分析:性别、病变部位、Huvos分级、切口长度、重建长度及术中出血量等因素,P<0.05。结论对于术中输血率极高的原发恶性骨肉瘤,应针对患者术中输血的高危因素进行提前干预,精准制定患者术前备血计划,在保障手术安全的前提下有效降低输血率及输血量。Objective To provide reference for formulating preoperative blood preparation plan for malignant osteosarcoma scientifically and rationally under the persistent COVID-19 epidemic by studying the high-risk influencing factors related to intraoperative blood transfusion in patients with primary malignant osteosarcoma.Methods The general data,preoperative blood routine and coagulation parameter,clinicopathological record and surgical data of 120 patients with primary malignant osteosarcoma in Beijing Jishuitan Hospital from January 2020 to January 2021 were retrospectively analyzed by univariate analysis,multivariate regression analysis and Pearson correlation analysis to determine the high risk factors for intraoperative blood transfusion in patients with primary malignant osteosarcoma.Results The incidence of intraoperative and postoperative blood transfusion of malignant osteosarcoma patients were 48.33%(58/120)and 62.50%(75/120),with the average blood transfusion units at(1.36±1.14)U and(2.93±2.26)U,respectively.The univariate analysis showed that such factors as sex,preoperative Hct(%),preoperative Plt(×10;/L),location of lesion,Huvos classification,incision length(cm),reconstruction length(cm)and intraoperative blood loss(mL)were significantly different(P<0.05).Multivariate logistic regression analysis showed that sex,location of lesion,Huvos classification,incision length(cm),reconstruction length(cm)and intraoperative blood loss(mL)were significantly different(P<0.05).Conclusion For primary malignant osteosarcoma with a high rate of intraoperative blood transfusion,early intervention should be carried out according to the high-risk factors of intraoperative blood transfusion,and preoperative blood preparation plan should be accurately formulated to effectively reduce the rate and units of blood transfusion in patients under the premise of surgery safety.

关 键 词：原发恶性骨肉瘤 术中输血 输血影响因素 术前备血计划 

分 类 号：R457.1[医药卫生—治疗学] R738[医药卫生—临床医学]