肿瘤患者红细胞输注无效的影响因素分析

Influence Factors of Invalid Red Blood Cell Transfusion in Tumor Patients

[目的]分析肿瘤患者红细胞输注无效的相关因素,为临床肿瘤患者科学、有效的输血提供依据。[方法]回顾性分析2014年1月至2016年4月衢州市柯城区人民医院485例肿瘤患者红细胞输注无效与相关因素之间的关系,分析输血不良反应发生率与输血效果的关联性。用Logistic回归分析可能影响肿瘤患者红细胞输注无效的因素。[结果]肿瘤患者红细胞输注无效比例为21.65%(105/485)。单因素分析显示肿瘤患者红细胞输注无效与既往输血次数、既往输血量及妊娠次数密切相关;迟发型溶血反应的发生率与肿瘤患者红细胞输注效果密切相关。Logistic回归分析显示多次输血(OR=8.48,P=0.00)是肿瘤患者红细胞输注无效的独立危险因素。[结论]有多次输血史的肿瘤患者发生红细胞输注无效的风险较高。针对有反复输血史的肿瘤患者,应制定独立、安全、有效的个体化输血策略。

[Objective] To analyze the related factors associated with invalid red blood cell transfusion in tumor patients, and to provide evidence for scientific and effective clinical blood transfusion. [Methods] The retrospective analysis of the relationship between invalid red blood cell transfusion and related factors in 485 tumor patients in Quzhou Kecheng People＇s Hospital from January 2014 to April 2016 was enrolled. The relationship between the incidence of tansfusion adverse reactions and the effectiveness of blood transfusion were analyzed. The potential factors associated with invalid red blood cell transfusion in tumor patients were evaluated by Logistic regression. [Results] The proportion of invalid red blood cell transfusion in tumor patients was 21.65%（105/485）. The single factor analysis showed that the number of always blood transfusion , the volume of always blood transfusion, and the number of pregnancy were closely related to invalid red blood cell transfusion in tumor patients. The incidence rate of late onset hemolytic reaction was closely related to the effectiveness of red blood cell transfusion in tumor patients. Logistic regression analysis showed that multiple transfusions（OR=8.48,P=0.00） were independent factors for invalid red blood cell transfusion in tumor patients . [Conclusion] The tumor patients with history of multiple transfusions are at high risk for invalid blood transfusion. For the tumor patients with repeated blood transfusion history,the independent,safe and effective individualized transfusion strategy should be formulated.