肝移植术中输注病毒灭活血浆与冰冻血浆对术后指标的影响对比分析  

Comparative analysis of the effects of virus inactivated plasma and frozen plasma transfusion on postoperative indicators during liver transplantation

作　　者：熊春花[1] 徐荣华[1] 高红强[2] 苏纲[3] 侯星羽 邢亚萍[1] 吉学林 陶娅[4] XIONG Chunhua;XU Ronghua;GAO Hongqiang;SU Gang;HOU Xingyu;XING Yaping;JI Xuelin;TAO Ya(Department of Blood Transfusion,Kunming First People's Hospital,Kunming,Yunnan 650011,China;Department of Hepatobiliary Surgery,Kunming First People's Hospital,Kunming,Yunnan 650011,China;Department of Anesthesiology,Kunming First People's Hospital,Kunming,Yunnan 650011,China;Operating Room,Kunming First People's Hospital,Kunming,Yunnan 650011,China)

机构地区：[1]昆明市第一人民医院输血科,云南昆明650034 [2]昆明市第一人民医院肝胆外科,云南昆明650034 [3]昆明市第一人民医院麻醉科,云南昆明650034 [4]昆明市第一人民医院手术室,云南昆明650034

出　　处：《国际检验医学杂志》2024年第S02期46-50,共5页International Journal of Laboratory Medicine

基　　金：肝、肾器官移植关键技术研究与应用(202302AA310018);昆明市卫生健康委员会卫生科研课题项目(2023-04-10-001)。

摘　　要：目的探讨肝移植术中输注病毒灭活血浆与输注普通血浆(包括新鲜冰冻血浆和普通冰冻血浆)的疗效差异,为肝移植患者输注病毒灭活血浆的有效性提供实验和理论依据。方法回顾性分析2018年1月至2023年9月期间在本院施行肝移植术的154例患者,根据术中输注血浆的不同,先将患者分为病毒灭活血浆组与普通血浆组。随机在两组内各选取36例患者进行研究。统计学分析比较两组患者基本资料、手术前后相关肝功能指标、凝血指标及术中相关变量的变化。结果两组患者基本资料包括性别、年龄、身高、体重、血型,及术前实验室指标TP、TBIL、IBIL、ALB、ALT、AST、FIB、APTT、PT、INR经过组间比较结果显示,仅ALB微有差异(P<0.05),其余指标差异无统计学意义(P>0.05);术后两组患者TP、TBIL、IBIL、ALB、ALT、AST、FIB、APTT、PT、INR差异均无统计学意义(P>0.05),术中变量包括术中输血浆量、术中输冷沉淀量、术中输血小量板、术中失血量、术中并发症心脏骤停(%)差异均无统计学意义(P>0.05)。结论肝移植患者术中输注病毒灭活血浆与普通血浆疗效无显著差异,但目前认为病毒灭活血浆安全性更高。适合肝移植术中开展应用。Objective To investigate the differences in therapeutic efficacy between the infusion of virus inactivated plasma and the infusion of regular plasma(including fresh frozen plasma and regular frozen plasma)during liver transplantation,and to provide experimental and theoretical basis for the effectiveness of virus inactivated plasma infusion in liver transplant patients.Methods A retrospective analysis was performed on 154 patients who underwent liver transplantation in the hospital from January 2018 to September 2023.According to the difference of intraoperative plasma infusion,the patients were divided into two groups:virus inactivated plasma group and common plasma group,and 36 patients in each group were randomly selected for study(n=36).The changes of basic data,liver function indexes,coagulation indexes and intraoperative variables were statistically analyzed and compared between the two groups.Results The basic data of the two groups included gender,age,height,weight,blood type,and preoperative laboratory indexes TP,TBIL,IBIL,ALB,ALT,AST,FIB,APTT,PT and INR,and the results showed that only ALB had a slight difference(P<0.05).There were no significant differences in other indexes(P>0.05).There were no significant differences in TP,TBIL,IBIL,ALB,ALT,AST,FIB,APTT,PT and INR between the two groups after surgery(P>0.05).Intraoperative variables,including intraoperative plasma transfusion volume,intraoperative cryoprecipitation volume,intraoperative small blood transfusion plate,intraoperative blood loss,intraoperative complications of cardiac arrest(%),were not statistically significant(P>0.05).Conclusion There is no significant difference in the efficacy of infusing virus inactivated plasma during liver transplantation compared to regular plasma,but it is currently believed that virus inactivated plasma is safer.Suitable for application in liver transplantation surgery.

关 键 词：肝移植 病毒灭活血浆 冰冻血浆 相关指标 

分 类 号：R657.3[医药卫生—外科学]