高需求输血对食管癌切除术后恢复及相关生化指标变化的影响

Effect of high-demand blood transfusion on postoperative recovery of esophageal cancer and changes in related biochemical indicators

目的探讨食管癌患者围术期间高需求输血的原因,分析高需求输血对食管癌切除术后恢复及相关生化指标变化的影响。方法采用分层整群抽样方法选择2017年5月-2018年12月浙江省嘉兴市第一医院胸外科收治的58例食管癌患者,将食管癌切除术围术期间输血量≥1000 mL的29例患者分为观察组,输血量<1000 mL的29例患者分为对照组,分析高需求输血(输血量≥1000 mL)的原因和影响,包括住重症监护室时间、住院时间、食管癌切除术后并发症发生率、血小板计数和血钾、血钙水平。结果观察组患者并发症发生率(62.1%)高于对照组患者(31.0%),差异有统计学意义(P<0.05);观察组患者食管癌切除术中出血量高于对照组,住重症监护室和住院时间均长于对照组,差异均有统计学意义(均P<0.05);输血后观察组血小板计数低于对照组,差异有统计学意义(P<0.05);输血后观察组血钾、血钙水平均低于对照组,差异均有统计学意义(均P<0.05)。结论食管癌患者食管癌切除术围术期高需求输血的主要原因是术中出血,高需求输血会导致患者食管癌切除术后凝血功能增强,且食管癌切除术后并发症发生率会提高。

Objective To investigate the causes of high-demand blood transfusion during perioperative period of patients with esophagus cancer,and to analyze the effect of high-demand blood transfusion on postoperative recovery and related biochemical indicators.Methods A stratified cluster sampling method was used to select 58 patients with esophageal cancer admitted to the Department of Thoracic Surgery of the First Hospital of Jiaxing from May 2017 to December 2018,with 29 patients with blood transfusion volume≥1000 mL during the perioperative period of esophageal cancer resection were divided into the observation group,and 29 patients with blood transfusion volume<1000 mL were divided into the control group,the causes and effects of high-demand blood transfusion(blood transfusion volume≥1000 mL)were analyzed,with the length of stay in the intensive care unit,length of hospital stay,complication rate after esophageal cancer resection,platelet count and blood potassium and calcium levels included.Results The complication rate of the observation group(62.1%)was higher than that of the control group(31.0%),and the difference was statistically significant(P<0.05).The blood loss during resection of esophageal cancer in the observation group was higher than that in the control group,while the length of stay in the intensive care unit and hospital stay were both longer than those in the control group,and the differences were all statistically significant(all P<0.05).After blood transfusion,the platelet count of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After blood transfusion,the blood potassium and calcium levels of the observation group were lower than those of the control group,and the differences were all statistically significant(all P<0.05).Conclusion The main reason for the high-demand blood transfusion during perioperative period of esophageal cancer resection in patients with esophageal cancer is intraoperative bleeding.High-demand blood transfusion can lead to enhanced postoperative coagulation function and the incidence of complications after esophageal cancer resection will increase.