实验与检验医学
實驗與檢驗醫學
실험여검험의학
EXPERIMENTAL AND LABORATORY MEDICINE
2015年
1期
11-15
,共5页
大量输血%红细胞%死亡率%回顾性分析%多中心
大量輸血%紅細胞%死亡率%迴顧性分析%多中心
대량수혈%홍세포%사망솔%회고성분석%다중심
Massive blood transfusion%Red blood cell%Mortality%Retrospective analysis%Multicenter
目的：联合国内20家大型综合医院多中心回顾性调研外科住院患者大量输血病历1601例，分析探讨红细胞输注量与患者死亡率的关联性。方法联合全国20家三级综合医院进行多中心回顾性分析大量输血病例资料，根据24h内或72h内红细胞输注量分为：0~4U、5~9U、10~14U、15~19U、20~24U、25~29U、30~39U、40~U，8个组段，对红细胞输注不同量患者死亡情况进行分析，研究红细胞输注量与患者死亡率的关系。结果24h或72h内，红细胞输注总量≥10U后，患者死亡率随红细胞用量而增加，24h内红细胞应用10U~40U，死亡率为6.0%~38.9%；72h内红细胞应用10U~40U，死亡率为5.2%~28.0%；24h和72h红细胞在应用5U~9U组段者死亡率最低，分别是3.7%和2.3%；在0~4U组段，死亡率分别为7.3%和9.7%。结论外科住院患者大量输血时，24h或72h内红细胞输注量与死亡率有一定的关联性，患者死亡率随红细胞输注量增多而升高。
目的：聯閤國內20傢大型綜閤醫院多中心迴顧性調研外科住院患者大量輸血病歷1601例，分析探討紅細胞輸註量與患者死亡率的關聯性。方法聯閤全國20傢三級綜閤醫院進行多中心迴顧性分析大量輸血病例資料，根據24h內或72h內紅細胞輸註量分為：0~4U、5~9U、10~14U、15~19U、20~24U、25~29U、30~39U、40~U，8箇組段，對紅細胞輸註不同量患者死亡情況進行分析，研究紅細胞輸註量與患者死亡率的關繫。結果24h或72h內，紅細胞輸註總量≥10U後，患者死亡率隨紅細胞用量而增加，24h內紅細胞應用10U~40U，死亡率為6.0%~38.9%；72h內紅細胞應用10U~40U，死亡率為5.2%~28.0%；24h和72h紅細胞在應用5U~9U組段者死亡率最低，分彆是3.7%和2.3%；在0~4U組段，死亡率分彆為7.3%和9.7%。結論外科住院患者大量輸血時，24h或72h內紅細胞輸註量與死亡率有一定的關聯性，患者死亡率隨紅細胞輸註量增多而升高。
목적：연합국내20가대형종합의원다중심회고성조연외과주원환자대량수혈병력1601례，분석탐토홍세포수주량여환자사망솔적관련성。방법연합전국20가삼급종합의원진행다중심회고성분석대량수혈병례자료，근거24h내혹72h내홍세포수주량분위：0~4U、5~9U、10~14U、15~19U、20~24U、25~29U、30~39U、40~U，8개조단，대홍세포수주불동량환자사망정황진행분석，연구홍세포수주량여환자사망솔적관계。결과24h혹72h내，홍세포수주총량≥10U후，환자사망솔수홍세포용량이증가，24h내홍세포응용10U~40U，사망솔위6.0%~38.9%；72h내홍세포응용10U~40U，사망솔위5.2%~28.0%；24h화72h홍세포재응용5U~9U조단자사망솔최저，분별시3.7%화2.3%；재0~4U조단，사망솔분별위7.3%화9.7%。결론외과주원환자대량수혈시，24h혹72h내홍세포수주량여사망솔유일정적관련성，환자사망솔수홍세포수주량증다이승고。
Objective To explore the relationship between red blood cell transfusion volume and patients' mortality in mas-sive blood transfusion. Methods Multicenter retrospective research was carried out on 1601 surgical inpatients who receiving massive blood transfusion in 20 large comprehensive hospitals in China. According to red blood cell transfusion volume within 24 hours or 72 hours, they are divided into 8 groups: 0-4U, 5-9U, 10-14U, 15-19U, 20-24U, 25-29U, 30-39U, 40U-. The status of patients' death with different red blood cell transfusion volume was analyzed. Results Patients' mortality increases with the in-crease of red blood cell transfusion when total red blood cell transfusion volume ≥10U within 24 or 72 hours. Survival analysis based on different red blood cell transfusion volume was of statistical significance (χ2=72.857, P<0.001). Logistic regression analy-sis reveals that red blood cell transfusion volume was an independent risk factor (OR=0.52;CI:0.43-0.64; P<0.01) for death of pa-tients in massive blood transfusion. When red blood cells were transfused at 5U-9U volume within 24 and 72 hours, mortality is the lowest, which was 3.7% and 2.3% respectively. Conclusions During massive blood transfusion for surgical inpatients, there is some correlation between red blood cell transfusion volume within 24 or 72 hours and mortality of patients. Patients' mortality in-creases with the increase of red blood cell transfusion. Red blood cell transfusion volume, length of stay at hospital and intensive care unit constitute the independent risk factors for patients' death.
