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心脏移植患者围术期输血情况及大量输注红细胞影响因素分析 被引量:5

Analysis of perioperative blood transfusion and the influencing factors of mass-transfusion in patients underwent heart transplantation
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摘要 目的通过分析心脏移植患者围术期的输血情况及大量输注红细胞的影响因素,为临床预测用血和备血提供参考依据。方法回顾性收集本院心外科2014年3月~2022年1月完成的44例心脏移植患者的输血情况,统计患者信息包括年龄、性别、术前诊断、相关病史、心脏手术史、抗栓用药史、转流及主动脉阻断时间等,应用单因素分析方法和多因素Logistics回归方法分析心脏移植患者围术期大量输注红细胞的危险因素。结果44例心脏移植患者围术期成分输血率为100%。平均输注红细胞3.75(0,7.5)U(72.73%,32/44),血浆1140(597.5,1782.5)mL、(97.73%,43/44),冷沉淀10(9.5±10)U、(88.64%,39/44),血小板1(1,1.25)治疗量(86.36%,38/44)。其中大量输注红细胞率45.45%(20/44)。单因素分析:输红细胞≤4 U组(n=24)与输红细胞>4 U组(n=20)比较,包括术前使用抗栓治疗药物、出血量、体外循环时间都存在明显差异(P<0.05)。多因素Logistic回归分析:术前使用抗栓药物治疗者(n=15)为OR=5.900、95%CI=1.313~26.521(P<0.05);体外循环时间为OR=1.024、95%CI=1.000~1.049(P<0.05)。结论心脏移植患者围术期成分输血率高,术前使用抗栓药物治疗、体外循环时间长是大量输注红细胞的危险因素。 Objective To provide references for clinical prediction of blood preparation and blood consumption,as well as the influencing factors of mass-transfusion by analyzing the perioperative blood transfusion in patients underwent heart transplantation.Methods The blood transfusions of 44 patients with heart transplantation completed in the Department of Cardiac Surgery of our hospital from March 2014 to January 2022 were retrospectively collected.Patient information included age,gender,preoperative diagnosis,relevant medical history,history of cardiac surgery,and history of antithrombotic medication.The risk factors of perioperative red blood cell transfusion in patients with heart transplantation were analyzed by univariate analysis method and multivariate logistic regression method.Results All 44(100%)heart transplant patients received blood components:the average transfusion units of red blood cells was 3.75(0,7.5)U(72.73%),plasma 1140(597.5,1782.5)mL(97.73%),cryoprecipitate 10(9.5±10)U(88.64%),platelets 1(1,1.25)therapeutic amount(86.36%).The rate of massive transfusion of red blood cells was 45.45%(20/44).The univariate analysis found that there were significant differences in preoperative use of antithrombotic drugs,blood loss,and cardiopulmonary bypass time between the red blood cell transfusion group≤4 U(n=24)and the red blood cell transfusion group>4 U(n=20)(P<0.05).Multivariate Logistic regression analysis showed that preoperative antithrombotic drug treatment(n=15)was OR 5.900,95%CI 1.313~26.521(P<0.05)and cardiopulmonary bypass time was OR 1.024,95%CI 1.000~1.049(P<0.05).Conclusion The perioperative transfusion rate of blood components in cardiac transplant patients was high.The preoperative use of antithrombotic drugs,and prolonged cardiopulmonary bypass are risk factors for massive red blood cell transfusion.
作者 周雪莹 欧阳旭 郑伟 ZHOU Xueying;OUYANG Xu;ZHENG Wei(Department of Blood Transfusion,Northern Theater Command General Hospital,Shenyang 110000,China)
出处 《中国输血杂志》 CAS 2022年第8期824-828,共5页 Chinese Journal of Blood Transfusion
关键词 心脏移植 围术期输血 患者血液管理 危险因素 大量输血 heart transplantation perioperative blood transfusion patient blood management risk factors massive blood transfusion
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