影响初诊食管癌患者围手术期异体红细胞输注相关因素

Retrospective analysis of factors associated with peri-operational red cell transfusion in newly-diagnosed esophageal cancer

目的:分析需手术治疗的初诊食管癌患者围手术期间,除了术中出血之外,其他与输注异体红细胞相关的影响因素。方法:回顾性收集178例经手术治疗的食管癌患者的临床资料及输注异体红细胞情况,并对输血相关因素进行单因素和多因素Logistic回归分析。结果:178例食管癌患者中有23例输注1U及以上悬浮红细胞,输血率12.9%。单因素Logistic回归分析结果提示年龄、术前Hb浓度、术前白蛋白浓度、肿瘤TNM分期,是患者围手术期是否输注异体红细胞的影响因素(P<0.05)。多因素Logistic回归分析提示性别、体重指数、白细胞数量、食管癌长度、位置、手术方式、术前肺功能情况、患者血型、凝血常规情况对成分输血无显著影响(P>0.05)。结论:年龄、术前Hb浓度、术后肿瘤TNM分期,尤其是术前低白蛋白血症,是影响患者是否需要输注红细胞的影响因素。

Objective：To investigate the clinical factors which are related to allogeneic red blood cell transfusion （ARBCT） in newly-diagnosed esophageal cancer patients during peri-operational period. Method.. This is a retro- spective cohort study including 178 newly-diagnosed esophageal cancer patients. Firstly, we screened independent risk factors associated with peri-operational ARBCT by univariate Logistic regression analysis, then, the candidate factors were further verified by multivariate Logistic regression. Result： ARBCT rate in this corhort was 12.90/00. Age, peri-operational hemoglobin level, peri-operational hypoalbuminemia and tumor staging were candidate risk factors for peri-operational ARBCT by univariate Logistic regression analysis. In subsequent multivariate Logistic analysis, hypoalbuminemia was showed to be the only rsik factor associated with peri-operational ARBCT. Conclu- sion： To the best of our knowledge, other than age, peri operational hemoglobin level and tumor staging, it＇s the first study to show that peri-operational hypoalbuminemia might be the risk factor associated with peri-operational ARBCT.