肝移植围手术期输血的综合评估

发布时间：2018-04-09 00:34

本文选题：输血　切入点：肝移植　出处：《中国输血杂志》2017年07期

【摘要】：目的评估肝移植患者围手术期出血量、血液制剂输注情况。方法回顾性选取119名肝移植患者的病历资料,按年龄、性别、临床诊断(病种)分组,分析患者围手术前、术中和术后24 h的凝血指标,围手术期出血量,以及悬浮红细胞、冰冻血浆、冷沉淀凝血因子、单采血小板的输注情况。结果肝移植患者围手术期出血量及各血液制剂的输注量各项指标:按患者年龄、性别分组比较无明显差异(P0.05);按临床诊断的不同分组,各诊断组(原发性肝癌组、乙肝肝硬化组及重型肝炎组等)患者单采血小板输注量相近(P0.05);而悬浮红细胞(U)分别为8.4±11.9、16.2±15.7、18.1±13.5,冰冻血浆(U)分别为8.2±7.1、18.1±15.6、18.2±17.9,冷沉淀(U)分别为9.5±8.2、17.1±16.318.5±16.4等(P0.05);各诊断组围手术前、术后即时PT(s)分别为15.6±3.8、24.6±4.1,APTT(s)分别为44.3±5.8、84.9±9.2,TT(s)分别为20.4±4.5、40.1±6.2,及Fib(s)分别为2.6±0.8、1.3±0.9,(P0.05);而各诊断组间患者围手术后24 h PT、APTT、TT及Fib比较无明显差异(P0.05)。结论临床诊断不同的肝移植患者围手术期血液制剂的输注方案选择的科学、安全、合理对肝移植成功率及患者预后至关重要;各时间段凝血指标检测结果的评估对肝移植围手术期成分输血具有指导作用。
[Abstract]:Objective to evaluate the perioperative blood loss and transfusion of blood preparation in patients with liver transplantation.Methods the medical records of 119 patients with liver transplantation were retrospectively analyzed according to age, sex, clinical diagnosis (type of disease), coagulation index before operation, blood loss during perioperative period, and suspended red blood cell (RBC).Frozen plasma, cryoprecipitation coagulation factor, single platelet transfusion.Results the indexes of perioperative bleeding and transfusion of blood preparations in patients with liver transplantation were as follows: there was no significant difference in the age and sex of the patients, and there was no significant difference between the two groups according to the clinical diagnosis (primary liver cancer group).Conclusion it is very important for the success rate of liver transplantation and the prognosis of patients with liver transplantation for clinical diagnosis of different liver transplantation patients to select the transfusion scheme of perioperative blood preparation scientifically, safely and reasonably.The evaluation of coagulation parameters in each time period is helpful to the perioperative component transfusion in liver transplantation.
【作者单位】：上海长征医院输血科;
【基金】：上海市卫生和计划生育委员会科研课题(2014215) 上海市公共卫生重点学科建设项目(15GWZK0501)
【分类号】：R457.1;R657.3

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