去白悬浮红细胞储存时间对恶性肿瘤围手术期大量输血患者输血风险的影响

The effect of storage time of white suspended red blood cells on the risk of transfusion in patients with perioperative mass transfusion for malignant tumors

目的:探讨不同储存时间的去白悬浮红细胞输注对消化系统恶性肿瘤围手术期大量输血患者输血效果的影响。方法:选取2019年1月~2022年4月在长沙某医院确诊的围手术期需大量输血的消化系统恶性肿瘤患者102例,将51例储存时间≤2周的去白悬浮红细胞输注患者设为观察组,51例储存时间﹥2周的去白悬浮红细胞输注患者设为对照组。对两组输血有效率及输血前后血常规指标、电解质指标、肝功能指标、凝血功能指标变化情况和不良反应发生率进行比较分析。结果:两组患者输血有效率无显著差异。输血后,两组患者血红蛋白(Hb)、红细胞压积(HCT)、钾离子(K^(+))较输血前升高,总钙离子(TCa^(2+))、pH值较输血前下降,且观察组K^(+)低于对照组。输血后,观察组总胆红素(TBIL)、活化部分凝血活酶时间(APTT)较输血前升高,对照组TBIL、直接胆红素(DBIL)、APTT较输血前升高,且观察组TBIL、DBIL低于对照组。观察组不良反应发生率低于对照组。结论:与输注储存时间>2周的去白悬浮红细胞相比,消化系统恶性肿瘤围手术期大量输血患者术中输注储存时间≤2周的去白悬浮红细胞时输血有效率虽无显著变化,但输血风险较小,对患者血常规、电解质、肝功能和凝血功能的影响也较小。

Objective To investigate the effect of different storage times of white suspended red blood cell transfusion on the transfusion effect of perioperative massive transfusion in patients with digestive system malignant tumors.Methods 102 patients with malignant tumors of the digestive system who were diagnosed in hospital of changsha from January 2019 to April 2022 and needed massive blood transfusion during the perioperative period were selected,51 patients with leukocyte free suspension red blood cell infusion with storage time ≤2 weeks were set as the observation group,and 51 patients with de leucocyte suspension red blood cell infusion with storage time >2 weeks were set as the control group.The blood transfusion efficiency,blood routine indexes,electrolyte indexes,liver function indexes,coagulation indexes and the incidence of adverse reactions were compared and analyzed between the two groups.Results There was no significant difference in the effective rate between the two groups.After blood transfusion,hemoglobin (Hb),hematocrit (HCT) and potassium (K^(+)) in the two groups were increased compared with those before blood transfusion,while total calcium (TCa^(2+)) and pH were decreased compared with those before blood transfusion,and K^(+) in the observation group was lower than that in the control group.After blood transfusion,total bilirubin (TBIL) and activated partial thromboplastin time (APTT) in the observation group were higher than those before blood transfusion,while TBIL,direct bilirubin (DBIL) and APTT in the control group were higher than those before blood transfusion,and TBIL and DBIL in the observation group were lower than those in the control group.The incidence of adverse reactions in the observation group was lower than that in the control group.Conclusion With infusion storage time >2 weeks compared to white suspended red blood cells,patients with digestive system malignant tumor of perioperative blood transfusion in infusion storage time of 2 weeks or less to white suspended red blood cells transfusion efficient although there was no significant change,but the blood transfusion risk is small,the patients’ blood routine,the influence of electrolytes,liver function and blood coagulation function is lesser also.