中国输血杂志2018，Vol.31Issue(2)：175-180,6.DOI:10.13303/j.cjbt.issn.1004-549x.2018.02.023
体外循环下心脏瓣膜置换术患者围术期输血影响因素的研究
Study on the influence factors of blood transfusion in cardiac valve replacement patients with cardiopulmonary bypass
摘要
Abstract
Objective To analyze the risk factors associated with intraoperative blood transfusion and screen out the ones concerning the risk of blood transfusion in the preoperative period of cardiac valve replacement patients with cardiopulmonary bypass (CPB) . Methods For this retrospective study, a total of 1283 adult patient casesof Guizhou Provincial People's Hospital from Jan, 2014 to Nov, 2016 were enrolled in the Cardiac Surgery. 721 patients, aged 18—72, undergoing cardiac valve replacement surgeries with CPB, were divided into two groups depending on whetherallogeneic blood was transfused during or after CPB. Univariate analysis and multivariate logistic regression analysis were performedto investigate the risk factors affectingthe preoperative period blood transfusion. Results A total of 480(66. 57％) cases received blood transfusion, of which the CPB transfusion group accounted for25. 66％(185) whilethepost-CPB transfusion group accounted for58. 53％(422) . Multivariate logistic regression analysis indicated that the influence factors affecting transfusion during CPB were female gender (P＜0. 01), old age (60—74yr) (P＜0. 01), BMI (18. 5—23 Kg /m2 ) (P＜0. 01), BMI (24—27 Kg /m2 ) (P＜ 0. 01), BMI (> 28 Kg /m2 ) (P＜ 0. 01), preoperative fibrillation(P＜0. 01), two valve replacement (P＜0. 01), three valve replacement (P＜0. 05), NYHA Ⅳ (P＜0. 01), preoperative anemia(P＜0. 01) and diabetes (P＜0. 05); the influence factors affectingpost-CPB transfusion were age (P＜0. 01), BMI (P＜0. 01), preoperative anemia (P＜0. 01), operative time (P＜0. 01), bloodloss (P＜0. 01) . Conclusion female, older, low BMI, none preoperative fibrillation, two or more valve replacement, NYHAⅣ, preoperative anemia and diabetes were the risk factors affectingpatients receiving blood transfusion during CPB period; older, low BMI, preoperative anemia, prolonged operations and massive blood loss were the risk factors affectingpatients receiving blood transfusion post-CPB.关键词
输血/心肺转流术/心脏瓣膜置换术/风险因素Key words
blood transfusion/cardiopulmonary bypass/cardiac valve replacement/risk factors分类
医药卫生引用本文复制引用
李兰芳,方开云,何祥,刚绍鹏,彭林,马熠,蒋玲,朱焱..体外循环下心脏瓣膜置换术患者围术期输血影响因素的研究[J].中国输血杂志,2018,31(2):175-180,6.基金项目
贵州省科技计划项目(黔科合基础[2016]1089) （黔科合基础[2016]1089）
贵州省科技合作计划(黔科合LH 字[2015]7141) （黔科合LH 字[2015]7141）
贵州省科技计划项目(黔科合基础[2015]1089) （黔科合基础[2015]1089）
贵州省人民医院博士基金(GZSYBS[2015]05 号) （GZSYBS[2015]05 号）
贵阳市科技计划(筑科合[2013103]33号) （筑科合[2013103]33号）
贵州省科技计划(黔科合SY 字[2012]3107 号) （黔科合SY 字[2012]3107 号）
