肝癌肝切除的输血因素分析

Predictive factors of blood transfusion requirement in liver resection for hepatocellular carcinoma

目的探讨肝癌肝切除输血的预测因素。方法回顾性分析222例肝癌肝切除病例的临床资料,分析影响肝癌肝切除输血的临床因素。结果 Logistic单因素及多因素分析:肝硬化程度,肿瘤直径,大血管侵犯,切肝段数,谷草转氨酶,直接胆红素,间接胆红素,血红蛋白水平这8个变量为输血的独立影响因素(P<0.05),并依次建立了Logistic回归预测输血的方程式。结论通过对肝癌病人术前输血影响因素的分析,预测输血的概率,从而对高输血概率的肝癌病人选择实施自体输血,可以有效减少异体输血导致的不利影响。

Objective To investigate the predictive factors of blood transfusion in liver resection for hepatocellular carcinoma（HCC）.Methods The clinical data of 222 HCC patients undergoing liver resection were retrospectively analyzed to identify the clinicopathological factors that predict the probability of blood transfusion in liver resection for HCC.Results Following univariate logistic regression analyses,multivariate analyses were performed to identify the independent predictors of blood transfusion.The results revealed that eight variables could be as independent predictors of blood transfusion including cirrhosis,tumour size,main vessel invasion,resection extent,serum levels of aspartate aminotransferase,direct bilirubin and indirect bilirubin,and preoperative hemoglobin concentration.From these variables,a logistic regression equation was derived to predict the probability of blood transfusion.Conclusions Analysis of the preoperative factors of blood transfusion in HCC patients to predict the likelihood of transfusion can be used to identify patients who are at high risk for blood transfusion and therefore to employ autologous blood transfusion,which may decrease the disadvantages of allogeneic blood transfusion.