肾移植围术期用血情况及预后分析  

Analysis of perioperative blood transfusion and prognosis in kidney transplantation

作　　者：李瑞平 蒋波笛 孟祥红 Li Ruiping;Jiang Bodi;Meng Xianghong(Department of Blood Transfusion Medicine,8th Medical Center of PLA General Hospital,Beijing 100091,China)

机构地区：[1]中国人民解放军总医院第八医学中心输血医学科,北京100091

出　　处：《实用器官移植电子杂志》2023年第6期533-537,共5页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：首都临床特色应用研究与成果推广(Z161100000516180)。

摘　　要：目的 通过对肾移植患者围术期用血和实验室检测结果的变化进行分析,为临床肾移植患者围术期用血策略提供依据。方法 回顾性分析中国人民解放军总医院第八医学中心2016—2022年330例肾移植患者围术期的用血情况,分析比较237例肾移植围术期未用血患者与93例肾移植围术期用血患者术前常规血液检测指标差异性变化,对肾移植围术期用血患者与未用血患者术后发生免疫排斥反应及医院感染情况进行分析比较。结果 330例肾移植患者围术期用血比例为28.18%(93/330),围术期未用血与用血肾移植患者在术中失血量、手术时长及术前血红蛋白、红细胞比容、凝血酶原活动度等指标差异有统计学意义(P <0.05),330例肾移植患者术后医院感染发生率为4.55%(15/330),其中93例围术期用血患者发生医院感染的比例为9.68%(9/93),明显高于237例未用血患者(2.53%,6/237)(P <0.05),330例肾移植患者免疫排斥反应发生率为9.39%(31/330),其中93例围术期用血患者术后免疫排斥反应发生率为12.90%(12/93),而237例未用血患者的免疫排斥反应发生率为8.02%(19/237),两组之间差异无统计学意义(P> 0.05)。结论 应加强对肾移植患者围术期的凝血功能监测,术前积极进行贫血治疗和凝血水平调控,尽量减少术中出血量和缩短手术时长,合理利用血液资源,提高肾移植患者的输血疗效,改善患者预后。Objective To analyze the changes of perioperative blood transfusion and laboratory test results of kidney transplantation patients,and to provide the basis for clinical judgment of perioperative blood transfusion strategy of kidney transplantation patients.Methods The perioperative blood transfusion of 330 patients with kidney transplantation in 8th Medical Center of PLA General Hospital from 2016 to 2022 was retrospectively analyzed.The difference of preoperative routine blood test indexes between 237 patients without blood transfusion and 93 patients with blood transfusion during perioperative period of kidney transplantation were analyzed and compared.The immune rejection and nosocomial infection after kidney transplantation between perioperative blood transfusion patients and without blood transfusion patients were analyzed and compared.Results The proportion of perioperative blood transfusion in 330 kidney transplantation patients was 28.18%(93/330).There were statistically significant differences in intraoperative blood loss,operation duration,preoperative hemoglobin,hematocrit,prothrombin activity and other indexes between patients without blood transfusion and with blood transfusion during the perioperative period of kidney transplantation(P < 0.05).The incidence of nosocomial infection was 4.55%(15/330) in 330 patients with kidney transplantation,and 9.68%(9/93) in 93 patients with perioperative blood transfusion,which was significantly higher than that in 237 patients without blood transfusion(2.53%,6/237)(P < 0.05).The incidence of immune rejection in 330 patients with kidney transplantation was 9.39%(31/330),including 12.9%(12/93)in patients with perioperative blood transfusion was,and 8.02%(19/237)in patients without blood transfusion.There was no significant difference between the two groups( P > 0.05).Conclusion It is necessary to strengthen the monitoring of perioperative coagulation function of kidney transplantation patients,actively preoperative anemia treatment and coagulation level regulation

关 键 词：肾移植 围术期 用血 

分 类 号：R699.2[医药卫生—泌尿科学]