中国肝胆及胃肠恶性肿瘤患者围手术期贫血的现状调查

Investigation of perioperative anemia in patients with hepatobiliary and gastrointestinal malignancies in china

目的调查肝胆及胃肠恶性肿瘤患者围手术期贫血的现状。方法回顾性收集2013年1月—2018年12月在三甲综合、专科医院住院且明确诊断的肝胆、胃肠道恶性肿瘤患者78 674例,其中肝胆恶性肿瘤患者18 660例,胃肠道恶性肿瘤60 014例。对其贫血发生情况进行分析。结果肝胆、胃肠道恶性肿瘤患者男性多于女性,男性占67%;与胃肠道恶性肿瘤患者相比,肝胆恶性肿瘤患者男性占比更高(P<0.01);患者多集中在50-79岁,该人群占总体的80%;调查患者中术前贫血发生率为30%,其中轻度贫血最多,占总体的20%;肝胆恶性肿瘤贫血发生率为22%,胃肠道恶性肿瘤为32%,与肝胆恶性肿瘤相比,胃肠道恶性肿瘤患者贫血程度不同(P<0.01);围手术期患者中近一半(49%)单独采用了输血的方式纠正贫血,有26%使用了包含EPO的干预方案纠正贫血;调查人群术后贫血情况较术前加重,术前血红蛋白指标正常的患者有50%出现术后贫血,术后贫血的患者仍以轻度贫血为主。结论目前肿瘤相关性贫血发生率较高,围手术期患者应给予合理的血液管理,改善患者的生活质量及治疗效果。

Objective To investigate the current status of perioperative anemia in patients with hepatobiliary and gastrointestinal malignancies in China.Methods 78 674 patients with hepatobiliary and gastrointestinal malignancies who were hospitalized in comprehensive and specialized hospital from 2013 to 2018,were collected retrospectively,including 18 660 patients with hepatobiliary malignancy and 60 014 patients with gastrointestinal malignancies.The incidence of anemia was analyzed.Results There were more males than females in hepatobiliary and gastrointestinal malignant tumors,and males accounted for 67%.Compared with gastrointestinal malignant tumors,the proportion of male patients with hepatobiliary malignancy was higher(P<0.01);the majority of patients were 50-79 years old,which accounted for 80%of the total;the incidence of preoperative anemia was 30%,among which mild anemia was the most,accounting for 20%of the total;the incidence of anemia of hepatobiliary malignancy was 22%,and gastrointestinal malignant tumors were 32%.Compared with hepatobiliary malignant tumors,the degree of anemia in patients with gastrointestinal malignancies was different(P<0.01);nearly half(49%)of perioperative patients used blood transfusion alone to correct anemia,and 26%used an EPO-containing intervention to correct anemia.The number of postoperative anemia patients increased,and 50%of patients with normal preoperative hemoglobin index had postoperative anemia.Conclusion The incidence of tumor-related anemia is high.Perioperative patients should be given reasonable blood management to improve the quality of life and treatment.