胆囊癌切除术围手术期输血与术后生存和无瘤生存的关系

Relationship between perioperative period blood transfusion and postoperative survival and tumor-free survival after cholecystectomy

目的探究胆囊癌切除术围手术期输血与术后生存和无瘤生存的关系。方法回顾性分析2015年6月至2019年6月于浙江省金华市人民医院和甘肃省人民医院接受胆囊癌切除术治疗的72例患者临床资料,根据患者围手术期是否输血分为输血组33例和非输血组39例。采用倾向性评分匹配对两组基本资料进行匹配。比较两组一般资料及2年总生存率、无瘤生存率,采用Cox风险回归模型分析患者术后生存和无瘤生存的危险因素。结果倾向性评分匹配后,72例患者中配对成功60例,输血组与未输血组各30例。两组一般资料比较,差异无统计学意义(P>0.05)。随访截至2021年6月,输血组、未输血组中位生存期分别为12、24个月。两组总生存期比较,差异有统计学意义(P<0.05);两组无瘤生存期比较,差异有统计学意义(P<0.05)。Cox风险回归模型分析显示,在矫正TNM分期、肝侵犯因素后,围手术期输血使患者死亡风险增加2.021倍,使患者肿瘤复发风险增加1.762倍。结论围手术期输血可降低胆囊癌切除术患者术后2年总生存率和无瘤生存率。

Objective To explore the relationship between perioperative period blood transfusion and postoperative survival and tumor-free survival after cholecystectomy.Methods The clinical data of 72 patients who underwent cholecystectomy in Jinhua People’s Hospital and Gansu Provincial People’s Hospital from June 2015 to June 2019 were retrospectively analyzed.The two groups of basic data were matched by propensity score matching.The general data,two-year overall survival rate,and tumor-free survival rate were compared between the two groups.Cox risk regression model was used to analyze the risk factors of postoperative survival and tumor-free survival.Results After propensity score matching,60 cases of the 72 patients were successfully matched,30 cases in the transfusion group and 30 cases in the non-transfusion group.There was no significant difference in general data between the two groups(P>0.05).The follow-up ended in June 2021,and the median survival time of the patients in the blood transfusion group and the non-transfusion group were 12 and 24 months,respectively.There was a statistically significant difference in the overall survival time between the two groups(P<0.05);there was a statistically significant difference in the tumor-free survival time between the two groups(P<0.05).Cox risk regression model analysis showed that after adjusting for TNM stage and liver invasion factors,perioperative blood transfusion increased the risk of death by 2.021 times and increased the risk of tumor recurrence by 1.762 times.Conclusion Perioperative blood transfusion reduces two-year overall survival and tumor-free survival in patients undergoing cholecystectomy.