体外循环瓣膜置换术围手术期红细胞悬液用量的术前因素分析

Preoperative Factors of Perioperative CRCs Consumption in CPB Valve Surgery

目的探讨影响体外循环（CPB）瓣膜置换术围手术期红细胞悬液（CRCs）用量的术前因素。方法收集2012年12月-2014年11月本院71例行择期手术的体外循环CPB瓣膜置换术患者的临床资料，对可能影响围手术期CRCs大量用血（≥8U）的术前影响因素，即年龄、体质指数（BMI）、左室射血分数（LVEF）、术前肌酐（Cr）、丙氨酸氨基转移酶（ALT）、外周血管病史、术前2周内房颤房扑、心功能，进行单因素Logistic回归筛选。再用多因素Logistic回归分析确认。结果经单因素Logistic回归分析，得出年龄、BMI、LVEF、术前Cr、外周血管病史有统计学意义（P均〈0．10）。多因素Logistic回归分析得出年龄、术前Cr、BMI（P均〈0．10，OR值分别为2．128，4．244，0．264）为影响因素。结论高龄、术前Cr水平异常增高、BMI低的患者，CPB瓣膜置换术围手术期CRCs用量≥8U的概率高，择期手术需备足血液。

Objective To study the preoperative factors of perioperative red blood cells suspension （CRCs） consumption in cardiopulmonary bypass （CPB） valve surgery. Methods Clinical data from 71 adult patients of selective CPB valve surgery during December 2012 to November 2014 were collected and analyzed. By binary logistic regression to find out risk factors of perioperative CRCs large consumption （≥ 8 U） in 5 variables （including age, body mass index （BMI）, left ventricular ejection fraction （LVEF）, preoperative creatinine （Cr）, alanine aminotransferase （ALT）, peripheral vascular disease history, atrial fibrillation and flutter in 2 weeks before surgery, cardiac function）. Results In single variable logistic regression, 5 variables were in the equation （age, BMI, LVEF, preoperative Cr and peripheral vascular disease history, P 〈0.10, respectively.）. In multivariable logistic regression, 3 variables were in the equation （age, preoperative Cr andBMI, P〈0. 10, OR= 2.128, 4.244 and 0. 264, respectively）. Conclusion More blood should be prepared for patients of elder, higher preoperative Cr and less BMI due to the possibility of the patients with perioperative CRCs in needs of large consumption（ ≥8 U）.