恶性肿瘤终末期患者输注血液制品的临床研究

Clinical Study of Infusion of Blood Products in Patients with Terminal Stage of Malignant Tumor

目的该研究旨在调查该中心的终末期恶性肿瘤患者输注血液制品的情况,以及分析输注血液制品对终末期患者生存期的影响,以对临床输注血液制品时机选择提供参考。方法采用回顾性研究方法,选取2015年9月—2017年9月该中心70例有完整随访记录的恶性肿瘤终末期患者。分为输血组和对照组,观察两组患者性别、年龄、ECOG评分、肿瘤类型等一般情况,分析输注血液制品对恶性肿瘤终末期患者的终末期生存时间的影响。结果输血组中29例患者(69.0%)输注了人血白蛋白、20例(47.6%)输注悬浮红细胞和18例(42.9%)输注血浆。两组患者在性别、年龄及体力状况评分方面均差异无统计学意义(P>0.05),总体患者的中位终末期生存期为3.0个月,两组患者之间无终末期的生存时间差异无统计学意义(P=0.715)。结论恶性肿瘤终末期患者输注血液制品并无生存获益。在临床实践中须严格把握输血指征,不提倡治疗肿瘤引起的慢性贫血以及临终前的无效输血。

Objective To investigate the blood products in patients with terminal stage of malignant tumors and analyze the effect of infusion of blood products on the patients in the terminal stage thus providing reference for the time choice of infusion of blood products. Methods 70 cases of patients with terminal stage of malignant tumors with complete follow-up records in our center from September 2015 to September 2017 were selected and divided into two groups, including the blood transfusion group and the control group, and the gender, age, ECOG score and tumor type of the two groups were observed, and the effect of infusion of blood products on the survival time of patients with terminal stage of malignant tumors was analyzed. Results In the blood transfusion group, 29 cases(69.0%)were infused with human serum albumin, 20 cases (47.6%)were infused with suspended red blood cells, and 18 cases (42.9%)were infused with plasma, and the differences in the gender, age and labor between the two groups were not statistically significant(P>0.05), and the survival period of patients was 3.0 months, and the difference in the survival time without the terminal stage between the two groups was statistically significant(P=0.715). Conclusion The infusion of blood products in the patients with terminal stage of malignant tumors has no the survival benefits, and we must master the blood transfusion signs strictly in the clinical practice, and the chronic anemia and ineffective blood transfusion before dying caused by the treating tumors are not advocated.