Abstract:

Objective To analyze the changes of perioperative blood transfusion and laboratory test results of kidney transplantation patients，and to provide the basis for clinical judgment of perioperativeblood transfusion strategy of kidney transplantation patients. Methods The perioperative blood transfusion of 330 patients with kidney transplantation in 8th Medical Center of PLA General Hospital from 2016 to 2022 was retrospectively analyzed. The difference of preoperative routine blood test indexes between 237 patients without blood transfusion and 93 patients with blood transfusion during perioperative period of kidney transplantation were analyzed and compared. The immune rejection and nosocomial infection after kidney transplantation between perioperative blood transfusion patients and without blood transfusion patients were analyzed and compared. Results The proportion of perioperative blood transfusion in 330 kidney transplantation patients was 28.18%（93/330）. There were statistically significant differences in intraoperative blood loss，operation duration，preoperative hemoglobin， hematocrit，prothrombin activity and other indexes between patients without blood transfusion and with blood transfusionduring the perioperative period of kidney transplantation（P ＜ 0.05）. The incidence of nosocomial infection was 4.55%（15/330）in 330 patients with kidney transplantation，and 9.68%（9/93）in 93 patients with perioperative blood transfusion，which was significantly higher than that in 237 patients without blood transfusion（2.53%，6/237）（P ＜ 0.05）. The incidence of immune rejection in 330 patients with kidney transplantation was 9.39%（31/330），including 12.9%（12/93）in patients with perioperative blood transfusion was，and 8.02%（19/237）in patients without blood transfusion. There was no significant difference between the two groups（P ＞ 0.05）. Conclusion It is necessary to strengthen the monitoring of perioperative coagulation function of kidney transplantation patients，actively preoperative anemia treatment and coagulation level regulation，minimize intraoperative blood loss and shorten operation duration，rationally utilize blood resources，improve the transfusion efficacy of kidney transplantation patients are necessary to improve the prognosis of patients. 

Key words:

Kidney transplantation, Perioperative, Blood transfusion

摘要：

目的 通过对肾移植患者围术期用血和实验室检测结果的变化进行分析，为临床肾移植患者围术期用血策略提供依据。 方法 回顾性分析中国人民解放军总医院第八医学中心 2016 — 2022 年 330 例肾移植患者围术期的用血情况，分析比较 237 例肾移植围术期未用血患者与 93 例肾移植围术期用血患者术前常规血液检测指标差异性变化，对肾移植围术期用血患者与未用血患者术后发生免疫排斥反应及医院感染情况进行分析比较。 结果 330 例肾移植患者围术期用血比例为 28.18%（93/330），围术期未用血与用血肾移植患者在术中失血量、手术时长及术前血红蛋白、红细胞比容、凝血酶原活动度等指标差异有统计学意义（P ＜ 0.05），330 例肾移植患者术后医院感染发生率为 4.55%（15/330），其中 93 例围术期用血患者发生医院感染的比例为9.68%（9/93），明显高于 237 例未用血患者（2.53%，6/237）（P ＜ 0.05），330 例肾移植患者免疫排斥反应发生率为 9.39%（31/330），其中 93 例围术期用血患者术后免疫排斥反应发生率为 12.90%（12/93），而 237 例未用血患者的免疫排斥反应发生率为 8.02%（19/237），两组之间差异无统计学意义（P ＞ 0.05）。 结论 应加强对肾移植患者围术期的凝血功能监测，术前积极进行贫血治疗和凝血水平调控，尽量减少术中出血量和缩短手术时长，合理利用血液资源，提高肾移植患者的输血疗效，改善患者预后。 

关键词:

肾移植 , 围术期 , 用血