围手术期不输血行食管癌切除术的可行性研究

Study on the Feasibility of Esophagectomy Without Blood Transfusion for Patients with Esophageal Carcinoma

目的 探讨围手术期不输血完成食管癌切除术的可行性。方法 １９９６ 年１ 月１９９８ 年３ 月共施行食管鳞癌切除术６１５ 例，将其分为两组，输血组：１９９６ 年１ 月１９９７ 年１ 月围手术期常规输血的食管癌手术患者２７９ 例；不输血组：１９９７ 年２ 月１９９８ 年３ 月围手术期不输血食管癌手术患者３３６ 例，比较两组的相关指标。 结果 输血组与不输血组比较，术中出血量，手术前后外周血血红蛋白含量，红细胞、血小板计数，出、凝血时间和术后感染性并发症的发生率均无差异（ Ｐ＞ ０ ．０５） ；围手术期输血量差异有显著性（ Ｐ＜ ０ ．０１） ；胸腔引流穿刺量输血组大于不输血组（ Ｐ＜ ０－０５） 。 结论 食管癌手术客观上存在不输血而顺利完成的可能性，围手术期不输血不影响食管癌手术质量及安全性。

Objective To investigate the feasibility without blood transfusion in esophagectomy for patients with esophageal carcinoma. Methods From Jan. 1996 to Mar. 1998, 615 cases with esophageal carcinoma underwent esophagectomy. The patients were divided into two groups, blood transfusion group (n=279, from Jan 1996 to Jan 1997) and no transfusion group (n=336,from Feb. 1997 to Mar. 1998). The data were analyzed between transfusion and no transfusion group. Results There was no differences in the amount of operative hemorrhage, the content of hemoglobin, the count of red blood cell and boold platelet count, the coagulation time and bleeding time and the postoperative infection morbidity perioperation( P>0.05) . The amount of transfused blood was larger in transfusion group than that in no transfusion group ( P<0.01) . The amount of thoracic drainage was larger in transfusion group than in no transfusion group ( P<0.05) . Conclusion It is possible that esophagectomy may be performed without blood transfusion, which does not affect the quality and safety of surgery.