结、直肠肿瘤患者围术期输血与术后感染的关系

Relationship between perioperative allogeneic blood transfusion and postoperative infection in patients undergoing colorectal cancer surgery

目的 探讨结、直肠肿瘤患者围术期输血与术后感染之间的关系。方法 收集213例于2001年在中山大学附属第一医院外科一区行结、直肠肿瘤根治术的病例,通过多因素分析校正了混杂因素的影响后,判断围术期输血与术后感染的关系。结果 输血的患者术后感染发生率明显高于未输血的患者(P<0.01)。在校正了对输血及术后感染均有影响的混杂因素的影响后,输血与不输血的患者发生术后感染的优势比值为1.133(P<0.01)。Logistic回归得出的回归预测方程为P(I)=1/[1+e-(-2.756+0.125U)]。结论 异体输血是导致受血者术后感染的独立危险因素。输血与术后感染之间存在量效关系,但是这种因果联系较弱,提示输血是术后感染的助因。

Objective To investigate the relationship between perioperative allogeneic blood transfusion and postoperative infection. Methods The records of 213 consecutive patients undergoing elective radical resection of colorectal cancer at the first Affiliated Hospital of Zhongshan University from January 1st, 2001 to December 31st, 2001 were reviewed. The association of allogeneic blood transfusion with postoperative infection was analyzed by logistic regression. Correction for multiple analysis were made to eliminate the effects of confounding factors. Results Among the patients who received transfusion the incidence of postoperative infection was higher than that among those who received no allogeneic blood ( P < 0.01) . After correction of the effects of the risk factors which might contribute to postoperative infection, the odds ratio of postoperative infection in patients who received allogeneic biood to those who received no allogeneic blood was 1.133 ( P < 0.01). The logistic regression equation was :P(I) = 1/[1 + e-(-2.756 + 0.125U] .Conclusion After correction of the effects of the risk factors which may contribute to postoperative infection, allogeneic blood transfusion is an independent risk factor of postoperative infection. There is a cause and effect relationship between allogeneic blood transfusion and postoperative infection, but the magnitude of this causal relationship is small. Allogeneic blood transfusion may cause an increased incidence of postoperative infection in a dose-dependent manner. The more allogeneic blood is transfused, the higher is the morbidity of postoperative infection.