亚临床甲减对成人心脏瓣膜手术患者围术期输血情况及预后的影响  

Effect of subclinical hypothyroidism on perioperative blood transfusion and prognosis in adult heart valve surgery

作　　者：刘淼 李甫罡[2] 陈涛[2] 卢峰[2] 毛文杰[3] LIU Miao;LI Fu-gang;CHEN Tao;LU Feng;MAO Wen-jie(Department of Transfusion Medicine;Department of Laboratory Medicine;Department of Anesthesia and Surgery,the People's Hospital of Jianyang City,Chengdu 641400,Sichuan,China)

机构地区：[1]简阳市人民医院输血科,四川成都641400 [2]简阳市人民医院检验科,四川成都641400 [3]简阳市人民医院麻醉手术部,四川成都641400

出　　处：《川北医学院学报》2024年第8期1132-1135,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨成人心脏瓣膜手术患者术前合并亚临床甲状腺功能减退症(SCH)对围术期输血情况及预后的影响。方法:选取929例择期行心脏手术的患者为研究对象,根据血清促甲状腺激素(TSH)水平将患者分为亚临床甲减组(SCH组,n=208)与甲状腺功能正常组(N组,n=721)。应用多因素回归模型分析患者术前合并亚临床甲减对住院期间输血情况、ICU停留时间、住院时间及住院期间死亡率的影响。结果:未校正前,SCH组与N组围术期输血率、输血量、住院时间、住院期间死亡率比较,差异均无统计学意义(P>0.05);ICU停留时间两组患者有统计学差异(P<0.05)。多因素回归分析显示,术前合并SCH与围术期输血率、住院时间无相关性(P>0.05),但其是围术期输血量增加及ICU停留时间延长的独立危险因素(P<0.05)。结论:在择期成人体外循环心脏瓣膜手术中,患者术前合并SCH不增加围术期的输血风险,但与发生输血的患者中红细胞用量增加有关,也与ICU停留时间延长有关。Objective:To explore the effect of preoperative subclinical hypothyroidism(SCH)on perioperative blood transfusion and prognosis in adult patients undergoing heart valve surgery.Methods:929 patients who underwent elective cardiac surgery were selected as the research subjects.According to the thyroid-stimulating hormone(TSH)levels,they were divided into two groups:SCH group(n=208)and Normal group(N group,n=721).Multivariate regression model was used to analyze the impact of preoperative concurrent subclinical hypothyroidism on blood transfusion during hospitalization,ICU stay time,hospitalization time,and in-hospital mortality rate.Results:Before adjustment,there were no significant differences in perioperative transfusion rate,transfusion volume,hospital stay,and in-hospital mortality between the SCH and N groups(P>0.05).However,ICU stay showed a significant difference between the two groups(P<0.05).Multivariate regression analysis indicated that preoperative SCH was not associated with perioperative transfusion rate or hospital stay(P>0.05),but SCH was an independent risk factor for increased perioperative transfusion volume and prolonged ICU stay(P<0.05).Conclusion:In adults undergoing elective heart valve surgery,preoperative SCH does not increase the risk of perioperative transfusion,but is associated with increased red blood cell use in transfused patients and prolonged ICU stay.

关 键 词：输血 亚临床甲减 成人 心脏瓣膜手术 

分 类 号：R457.1[医药卫生—治疗学]