不同临床特征肝病患者肝移植术中输血量的比较

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摘要目的比较不同临床特征肝病患者肝移植的术中输血量。方法回顾性分析2018年10月至2019年10月于首都医科大学附属北京佑安医院收治的96例肝移植手术患者的临床资料，比较不同性别、年龄、基础肝病、手术方式患者的术中输血量，比较不同基础肝病患者的术前凝血指标。结果不同性别及年龄患者术中输注的悬浮红细胞、血浆、血小板比较，差异无统计学意义（P＞0.05）。不同基础肝病患者术前的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）及纤维蛋白原（Fib）比较，差异有统计学意义（P＜0.05）。急慢性肝衰竭患者术前的PT、APTT均长于原发性肝癌、肝炎肝硬化及其他肝病，TT短于原发性肝癌、肝炎肝硬化及其他肝病，Fib低于原发性肝癌、肝炎肝硬化及其他肝病，差异有统计学意义（P＜0.05）。不同基础肝病患者术中输注的悬浮红细胞、血浆比较，差异有统计学意义（P＜0.05）；不同基础肝病患者术中输注的血小板比较，差异无统计学意义（P＞0.05）。急慢性肝衰竭患者术中输注的悬浮红细胞、血浆均大于原发性肝癌及肝炎肝硬化，差异有统计学意义（P＜0.05）；其他肝病患者术中输注的悬浮红细胞、血浆均大于原发性肝癌，差异有统计学意义（P＜0.05）。不同手术方式患者术中输注的悬浮红细胞、血浆、血小板比较，差异无统计学意义（P＞0.05）。结论肝移植患者血液需求量必须通过评估术前因素来个体化，合理掌握输血指征，保证足够的血液供应并减少相关的并发症。

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	杨耿侠
	黄晓婕

关键词 ：肝移植, 成分输血, 凝血功能, 肝病

Abstract：Objective To compare the blood transfusion volume in patients with different clinical characteristics of liver diseases during liver transplantation. Methods The clinical data of 96 patients with liver transplantation admitted to Beijing Youan Hospital Affiliated to Capital Medical University from October 2018 to October 2019 were analyzed retrospectively. The intraoperative blood transfusion volume of patients with different sex, age, basic liver disease and operation methods were compared. The preoperative coagulation indexes in patients with different basic liver diseases was compared. Results There were no significant differences in suspended red blood cells, plasma and platelets transfused in patients of different sex and age (P>0.05). There were significant differences in prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (Fib) of patients with different basic liver diseases before operation (P<0.05). The preoperative PT and APTT of patients with acute and chronic liver failure were longer than those of patients with primary liver cancer, hepatitis cirrhosis and other liver diseases, the preoperative TT of patients with acute and chronic liver failure was shorter than that of patients with primary liver cancer, hepatitis cirrhosis and other liver diseases, the preoperative Fib of patients with acute and chronic liver failure was lower than that of patients with primary liver cancer, hepatitis cirrhosis and other liver diseases, the differences were statistically significant (P<0.05). There were significant differences in suspended red blood cells and plasma transfusion in patients with different basic liver diseases (P<0.05). There was no significant difference in platelet transfusion between patients with different basic liver diseases (P>0.05). The suspended red blood cells and plasma transfusions in patients with acute and chronic liver failure were significantly higher than those in patients with primary liver cancer and hepatitis cirrhosis, the differences were statistically significant (P<0.05). The suspended red blood cells and plasma transfusions in patients with other liver diseases were greater than those in patients with primary liver cancer, the differences were statistically significant (P<0.05). There were no significant differences in the transfusion of suspended red blood cells, plasma and platelets in patients with different operation methods (P>0.05). Conclusion The blood demand of liver transplantation patients must be individualized by evaluating preoperative factors, reasonably grasping the indications of blood transfusion, ensuring adequate blood supply and reducing related complications.

Key words： Liver transplantation Component transfusion Coagulation function Liver diseases

基金资助:国家“十三五”重大专项课题（2017ZX10201101）；.
北京市优秀人才培养资助项目（2018000021223ZK04）。

引用本文:

杨耿侠；黄晓婕. 不同临床特征肝病患者肝移植术中输血量的比较[J]. 中国当代医药, 2022, 29(20): 52-54转69.
YANG Gengxia ； HUANG Xiaojie. Comparison of blood transfusion volume in patients with different clinical characteristics of liver diseases during liver transplantation. 中国当代医药, 2022, 29(20): 52-54转69.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I20/52

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