围手术期输血与肝脏术后感染并发症的关系  

Correlation Between Perioperative Blood Transfusion and Hepatic Postoperative Infection

作　　者：蒲青凡[1] 严律南[2] 孙碎康[1] 张川蓉[1] 曹高健[1] 戴华卫[1] 陈展伟[1] 李荣祥[3] 

机构地区：[1]温州医学院附属第三医院外二科,浙江瑞安325200 [2]四川大学华西医院普外科,成都610041 [3]四川省攀枝花市第五人民医院肝胆胰外科,攀枝花617000

出　　处：《中国普外基础与临床杂志》2003年第2期144-146,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的　回顾性分析 1 30例肝脏手术患者围手术期输血与术后感染并发症发生率和死亡率的关系 ,探讨减少肝脏手术中失血的措施。方法　将 1 30例肝脏手术患者根据围手术期输血与否分为输血组 (78例 )和未输血组 (52例 ) ,对两组患者术后淋巴细胞总数、感染并发症发生率及死亡率、术后抗生素应用时间及住院时间进行比较。结果　输血组术后淋巴细胞总数明显低于未输血组 (P<0 .0 5) ,术后感染并发症的发生率和死亡率分别为 38.5 %和 1 6 .7% ,均高于未输血组的 1 1 .5 %和 3 .8% (P<0 .0 5) ;术后抗生素应用时间和住院时间分别为 (9.7± 4 .2 )d和 (1 8.7± 1 3 .1 )d ,高于未输血组的 (5 .3± 2 .3)d和 (1 2 .7± 5 .2 )d (P<0 .0 0 1 )。结论　肝脏手术围手术期输血与术后感染并发症发生有关。采取有效措施控制肝脏手术中失血量和 /或减少输血量可能有助于降低术后感染并发症的发生率和死亡率。Objective To investigate the correlation between perioperative blood transfusion and hepatic postoperative infection. Methods One hundred and thirty patients undergoing hepatic operation were analyzed retrospectively on the relation of perioperative blood transfusion with postoperative infective morbidity and mortality in the period 1989-1999. The patients were divided into blood transfused group and nontransfused group. The major or minor hepatectomy was performed in 53 patients with hepatic malignancy and benign diseases. Results In the blood transfused group, the infective morbidity and perioperative mortality rate was 38.5% and 16.7% respectively, significantly higher than those in nontransfused group (11.5% and 3.8% respectively), P <0.05. The total lymphocyte count was lower in transfused group than that in nontransfused group. The postoperative antibiotics used time and length of hospital stay were (9.7± 4.2) days and (18.7±13.1) days respectively in transfused group than those in nontransfused group (5.3± 2.3) days and (12.7±5.2) days respectively. Conclusion The results suggest that hepatic postoperative infective morbidity and mortality are related with perioperative blood transfusion. Any strategy to reduce blood loss in liver surgery and decrease blood transfusion would be helpful to lower postoperative infective morbidity.

关 键 词：围手术期 输血 肝脏 术后感染 并发症 

分 类 号：R657.3[医药卫生—外科学]