新型冠状病毒肺炎输血患者的临床分析81例

Clinical analysis of COVID-19 blood recipients:81 patients

目的回顾性分析2020年2~3月武汉同济医院光谷院区新型冠状病毒肺炎患者的输血情况,总结输血病人的临床特点和用血情况。方法1)回顾分析81例输血患者各血液成分的使用情况。2)利用倾向得分匹配(propensity score matching,PSM,匹配项为新冠临床分型)对输血和未输血患者按1∶2的比例进行匹配,比较两组的临床特征。结果院区总输血率为5.5%(81/1463),88.9%(72/81)输血病人输注过红细胞。10例输注的红细胞量>20 U的患者,消化道出血和体外膜肺氧合(ECMO)治疗,其输注的红细胞、血浆、血小板和冷沉淀分别占院区总消耗量的48.3%(330/680)、57.5%(53500/93100)、36.2%(42/116)和62.3%(114.25/183.25)。相较于未输血组,入院时输血组炎症、感染和凝血功能相关指标更严重,治疗过程中病人出现急性肝、肾和心肌损伤的比例更高(P<0.01),ICU的入住率和死亡率更高(P<0.01)。结论新型冠状病毒肺炎输血病患入院相关机能指标和预后明显差于非输血病患。输血以输红细胞为主,极少数患者使用了大量的血液。

Objective To retrospectively analyze the transfusion records of COVID-19 patients from Feb to Mar 2020 in the Optical Valley Branch of Tongji Hospital in Wuhan,and summarize the clinical features and blood use of those patients.Methods 1)The utilization of blood components in 81 blood recipients were collected and retrospectively analyzed;2)Propensity score matching(PSM,by the clinical classification of COVID-19)was used to match the transfused and non-transfused patients according to the ratio of 1∶2,and the clinical features of the two groups were compared.Results The total transfusion rate in our hospital was 5.5%(81/1463),among which 88.9%(72/81)transfused red blood cell(RBC).Ten patients received RBC transfusion>20 U,consumed 48.3%(330/680)RBC,57.5%(53500/93100)plasma,36.2%(42/116)platelets,and 62.3%(114.25/183.25)cryoprecipitates due to ECMO or gastrointestinal bleeding.Compared to non-transfused patients,transfused patients showed worse lab-indexes related to inflammation,infection,and coagulation at admission,higher incidences of acute liver,kidney and cardiac injury,admission to the ICU and mortality(P<0.01).Conclusion The related functional indexes and prognosis of transfused COVID-19 patients were significantly worse than nontransfused ones.RBC transfusions were dominant,and massive blood transfusions were seldom.