中国输血杂志2025，Vol.38Issue(6)：772-776,5.DOI:10.13303/j.cjbt.issn.1004-549x.2025.06.004
肺移植患者术中输血及预后的影响因素研究
Influencing factors of intraoperative blood transfusion and prognosis in lung transplant patients
摘要
Abstract
Objective To explore the risk factors of allogeneic blood transfusion during lung transplant surgery and prognostic effects of transfusion by analyzing the basic data,surgical details,laboratory tests results,and intraoperative blood transfusion details during the perioperative period of lung transplant,so as to guide clinical blood use.Methods A retrospective analysis was conducted on the data of 319 patients who underwent lung transplantation surgery in our hospital from January 2022 to December 2023.The patients were divided into a non-transfusion group(n=70)and a transfusion group(n=249)based on their intraoperative blood transfusion status.The clinical data,surgical details,perioperative la-boratory results and other relevant preoperative and postoperative parameters were compared between the two groups,and the postoperative prognosis(improvement,non-recovery,and death)was analyzed.Results After comparison between the two groups of patients,it was found that the non-transfusion group had higher levels of preoperative Hb(g/L)(144.41±17.66 vs 129.78±20.44),preoperative Hct[43.25(40.23,47.5)vs 40.7(37,43.55)],preoperative TBIL(μmol/L)[11.45(9.15,15.3)vs 9.9(6.88,13.33)],and postoperative PLT(×109/L)(167.74±64.43 vs 132.37±54.84)than the trans-fusion group(all P<0.05).The non-transfusion group had lower levels of preoperative pCO2(mmHg)[41.4(37.4,45.8)vs 45.3(40,52.48)],postoperative TBIL(μmol/L)[25.45(17.68,33.95)vs 30.8(21.55,43.05)],postoperative pH(7.41±0.09 vs 7.45±0.10),bilateral lung transplantation[27(38.6%)vs 157(63.1%)],surgical duration(h)[5(4,7)vs 6.5(5,8)],use of ECMO[52(74.3%)vs 232(93.2%)],and intraoperative blood loss(mL)[600(500,800)vs 1 000(800,1 500)]compared to the transfusion group(all P<0.05).The items with P<0.1 in the compared indicators were in-cluded in the binary logistic regression analysis,and the results showed that bilateral lung transplantation,intraoperative blood loss,preoperative TBIL,postoperative PLT,postoperative TBIL,preoperative pCO2,and postoperative pH were sig-nificantly correlated with whether blood transfusion was performed(P<0.05).The P values of the Chi-square test for post-operative improvement and mortality in the non transfusion group and transfusion group were both greater than 0.05,indica-ting no statistically significant difference in the prognosis rate between the two groups of patients.Conclusion Bilateral lung transplantation,intraoperative blood loss,preoperative TBIL,and preoperative pCO2 are risk factors for blood transfu-sion during lung transplantation.Intraoperative blood transfusion has a significant impact on postoperative PLT,postopera-tive TBIL,and postoperative pH indicators,but has no significant effect on prognosis.A comprehensive evaluation of labo-ratory indicators and surgical details can help developing blood transfusion strategies more effectively.关键词
术中输血/肺移植/预后Key words
intraoperative blood transfusion/lung transplantation/prognosis分类
医药卫生引用本文复制引用
杨华莹,强新晨,孙玲玲,邵俊良..肺移植患者术中输血及预后的影响因素研究[J].中国输血杂志,2025,38(6):772-776,5.基金项目
江苏省输血协会英科新创科研基金资助项目(JSYK2023014) （JSYK2023014）
