中国输血杂志2025，Vol.38Issue(10)：1313-1319,1326,8.DOI:10.13303/j.cjbt.issn.1004-549x.2025.10.003
血小板与冷沉淀凝血因子术中输注策略对原位心脏移植患者围术期输血和预后的影响
Impact of intraoperative platelet and cryoprecipitate transfusion strategies on perioperative transfusion and out-comes in orthotopic heart transplant patients
摘要
Abstract
Objective To retrospectively compare the impact of different intraoperative transfusion strategies for plate-lets and cryoprecipitate on perioperative blood usage and clinical outcomes in patients undergoing orthotopic heart transplant(OHT),thereby providing a reference for perioperative patient blood management.Methods The clinical data of 65 pa-tients who had undergone OHT at our hospital between 2020 and 2025 were retrospective collected.Patient demographics,underlying chronic conditions,and perioperative(preoperative,intraoperative,and postoperative)laboratory blood test re-sults were analyzed.The transfusion volumes of intraoperative red blood cells,plasma,platelets,and cryoprecipitate were examined.Univariate and multivariate logistic regression models were employed to identify factors associated with periopera-tive outcomes.Results A total of 65 patients received allogeneic blood transfusion during the perioperative period.The ul-tilization of intraoperative platelets and cryoprecipitate was as follows:simultaneous transfusion of both platelets and cryopre-cipitate(at a 1∶1 ratio)was administered in 42 patients(64.62%),platelets alone in 12 patients(18.46%),and cryo-precipitate alone in 11 patients(16.92%).Patients who received simultaneous transfusion of platelets and cryoprecipitate(1∶1)(n=42)had a shorter ICU length of stay(32.45±10.18 d),while those who received either platelets or cryopre-cipitate alone(n=23)had a significantly longer ICU length of stay(68±15.97 d).Patients receiving simultaneous intrao-perative transfusion of platelets and cryoprecipitate also required fewer units of allogeneic red blood cells intraoperatively(median=4 units)and had a lower mortality rate(16.7%)than those receiving either product alone(26.1%),with a sta-tistically significant difference(P=0.023).Multivariate logistic regression analysis indicated that the volume of cryoprecip-itate transfused was an independent protective factor against postoperative allogeneic red blood cell transfusion(OR=0.344,95%CI[0.177,0.829],P=0.0159).Multivariate logistic regression also identified cryoprecipitate transfusion volume as an independent protective factor for ICU length of stay(OR=0.877,95%CI[0.719,0.986],P=0.0008),which was in line with the multivariate Cox regression results.Conclusion In patients undergoing OHT,the intraoperative transfusion strategy for platelets and cryoprecipitate influences the volume of perioperative allogeneic red blood cell transfusion and pa-tient mortality.Intraoperative cryoprecipitate transfusion volume is an independent protective factor against both postopera-tive allogeneic red blood cell transfusion and prolonged ICU length of stay.The establishment of a multidisciplinary collabo-rative blood management model,combined with the modification of perioperative blood utilization practices and the imple-mentation of a comprehensive patient blood management strategy,can holistically ensure perioperative patient safety.关键词
冷沉淀凝血因子/血小板/输血/原位心脏移植术/围手术期/死亡率Key words
cryoprecipitate/platelets/blood transfusion/orthotopic heart transplant/perioperative/mortality分类
医药卫生引用本文复制引用
张睿,罗晓琴,周梅,余凤秀,钱宝华,顾海慧..血小板与冷沉淀凝血因子术中输注策略对原位心脏移植患者围术期输血和预后的影响[J].中国输血杂志,2025,38(10):1313-1319,1326,8.基金项目
国家自然科学基金(81970165) （81970165）
