实用器官移植电子杂志 ›› 2020, Vol. 8 ›› Issue (4): 274-277.DOI: 10.3969/j.issn.2095-5332.2020.04.009

• 论著 • 上一篇    下一篇

肝移植受者术中输血影响因素分析

郝欢 1,孟祥红 1,宋继勇 2   

  1. 1. 解放军总医院第八医学中心输血科,北京 100091 ;  2. 北京解放军总医院第八医学中心肝胆科,北京 100091
  • 出版日期:2020-07-20 发布日期:2021-06-22
  • 基金资助:
    北京市科委首都临床特色课题(Z161100000516180)

Analysis of influencing factors of intraoperative blood use in liver transplant recipients

Hao Huan 1 ,Meng Xianghong 1 ,Song Jiyong 2 .   

  1. 1.Department of Clinical Transfusion in 8th clinical center,Beijing 100091, Chnia; 2. Department of Hepatobiliary Surgery in 8th clinical center,General Hospital of PLA,Beijing 100091,Chnia.
  • Online:2020-07-20 Published:2021-06-22

摘要:

目的 分析 132 例肝移植患者术中输血的影响因素,为肝移植手术合理输血提供理论依据。 方法 回顾性分析在解解放军总医院第八医学中心 2013 — 2017 年进行的 132 例肝移植受者术中输血情况, 分析输血量与患者术前危险因素的关系,并比较不同基础疾病组间术中输血量的差异,评估患者术前实 验室监测指标和疾病种类对术中血液成分输注的影响。结果 132 例肝移植患者术前、术中、术后输血率 分别是 10%、100%、98%,红细胞与血浆比例分别为 1.94 : 1、0.63 : 1 和 0.27 : 1 ;统计结果显示,术中输 血量与患者术前直接胆红素、总胆红素、血红蛋白、活化部分凝血酶时间以及凝血酶时间 5 个因素相关。 结论 肝移植术前应重视患者基础疾病和实验室指标如血栓弹力图结果以及直接胆红素、总胆红素、 血红蛋白、活化部分凝血酶时间以及凝血酶时间等,合理准备各类型血液成分,既保证肝移植术顺利进行, 又避免术前血液储备过剩而造成血液资源浪费。

关键词: 肝移植 , 输血 , 手术

Abstract:

Objective To offer rational of blood transfusion during liver transplantation by an analysis of perioperative blood transfusion in 132 patients with liver transplantation. Methods The blood transfusion in 132 liver transplantation patients from 2013 to 2017 were researched retrospectively,the effect of preoperative laboratory parameters and diverse primary diseases on perioperative blood transfusion in patients with liver transplantation were studied. The relationship was analyzed between perioperative blood transfusion and preoperative laboratory parameters. The amount difference of intraoperative blood transfusion was compared between groups of different primary diseases. Results The frequency of blood transfusion of 132 patients with preoperative,intraoperative and postoperative liver transplantation were 10%,100% and 98% respectively,the ratio of red blood cell and plasma were 1.94 : 1,0.63 : 1 and 0.27 : 1,and the results showed that the amount of intraoperative blood transfusesion was associated with factors including direct bilirubin,total bilirubin,hemoglobin,activated partial thromboplastin time, thrombin time and thromboela-stogram results. Conclusion The primary disease and preoperative laboratory index of patients with liver transplantation should be considered,and the blood ingredients could be prepared properly before operation to guarantee the operation would get on well and to avoid the waste of blood at the same time.

Key words: Liver Transplantation, Transfusion, Intraoperation