卵巢癌患者肿瘤细胞减灭术前低蛋白血症与围术期异体红细胞输注风险的相关性:单中心回顾性队列研究  

Association Between Preoperative Hypoalbuminemia and Risk of Perioperative Allogeneic Red Blood Cell in Patients Undergoing Cytoreductive Surgery for Ovarian Cancer:A Single-center Retrospective Cohort Study

作　　者：刘薇[1,2] 徐宵寒[2] 虞雪融 LIU Wei;XU Xiaohan;YU Xuerong(Graduate School,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院研究生院,北京100730 [2]中国医学科学院北京协和医院麻醉科,北京100730

出　　处：《协和医学杂志》2024年第4期839-844,共6页Medical Journal of Peking Union Medical College Hospital

基　　金：国家自然科学基金(72304281);中央高水平医院临床科研专项(2022-PUMCH-B-119)。

摘　　要：目的分析行肿瘤细胞减灭术的卵巢癌患者术前低蛋白血症与围术期异体红细胞输注风险的相关性。方法回顾性纳入2014年1月—2018年12月北京协和医院接受肿瘤细胞减灭术的卵巢癌患者。收集患者一般资料、术前血浆白蛋白、美国麻醉医师协会分级、术中出血量、手术时间、围术期(术中及术后3 d内)异体红细胞输注情况等临床资料,采用多因素Logistic回归法分析术前低蛋白血症(血浆白蛋白<35 g/L)与异体红细胞输注风险的相关性。结果共入选符合纳入与排除标准的卵巢癌患者1001例,其中术前低蛋白血症64例(6.4%),围术期接受异体红细胞输注481例(48.1%)。术前低蛋白血症患者围术期异体红细胞输注率高于非低蛋白血症患者[84.4%(54/64)比45.6%(427/937),P<0.001]。多因素Logistic回归分析校正美国麻醉医师协会分级、术中出血量、手术时间等混杂因素后显示,术前低蛋白血症与围术期异体红细胞输注风险显著相关(OR=5.68,95%CI:2.56~13.57,P<0.001)。结论术前低蛋白血症可增加行肿瘤细胞减灭术卵巢癌患者围术期异体红细胞输注风险。Objective To analyze the correlation between preoperative hypoproteinemia and the risk of perioperative allogeneic erythrocyte transfusion in ovarian cancer patients undergoing cytoreductive surgery.Methods Ovarian cancer patients who underwent cytoreductive surgery at Peking Union Medical College Hos-pital from January 2014 to December 2018 were retrospectively included.Clinical data such as the patients'general information,preoperative plasma albumin,American Society of Anesthesiologists(ASA)classification,intraoperative bleeding volume,operation time,perioperative(intraoperative and within 3 d postoperatively)allogeneic red blood cell transfusion were collected,and the correlation between preoperative hypoproteinemia(plasma albumin<35 g/L)and the risk of allogeneic red blood cell infusion was analyzed by using multivariate Logistic regression.Results A total of 1001 ovarian cancer patients who met the inclusion and exclusion crite-ria were enrolled,of which 64(6.4%)had preoperative hypoproteinemia and 481(48.1%)received periop-erative allogeneic red blood cell transfusion.The rate of perioperative allogeneic red blood cell transfusion was higher in the patients with hypoproteinemia than in those without hypoproteinemia[84.4%(54/64)vs.45.6%(427/937),P<0.001].Multivariate Logistic regression analysis corrected for confounders such as ASA classification,intraoperative bleeding volume,and operative time found that preoperative hypoproteinemia was significantly associated with the risk of perioperative allogeneic red blood cell transfusion(OR=5.68,95%CI:2.56-13.57,P<0.001).Conclusion Preoperative hypoalbuminemia could be associated with the in-creased risk of perioperative transfusion in patients undergoing cytoreductive surgery for ovarian cancer.

关 键 词：低蛋白血症 卵巢癌 肿瘤细胞减灭术 异体红细胞输注 

分 类 号：R614.2[医药卫生—麻醉学] R737.3[医药卫生—外科学]