• 1.溫州醫(yī)學(xué)院附屬第三醫(yī)院外二科(浙江瑞安325200);;
  • 2.四川大學(xué)華西醫(yī)院普外科(成都610041);;
  • 3.四川省攀枝花市第五人民醫(yī)院肝膽胰外科(攀枝花617000);

目的回顧性分析130例肝臟手術(shù)患者圍手術(shù)期輸血與術(shù)后感染并發(fā)癥發(fā)生率和死亡率的關(guān)系,探討減少肝臟手術(shù)中失血的措施。方法將130例肝臟手術(shù)患者根據(jù)圍手術(shù)期輸血與否分為輸血組(78例)和未輸血組(52例),對兩組患者術(shù)后淋巴細胞總數(shù)、感染并發(fā)癥發(fā)生率及死亡率、術(shù)后抗生素應(yīng)用時間及住院時間進行比較。結(jié)果輸血組術(shù)后淋巴細胞總數(shù)明顯低于未輸血組(P<0.05),術(shù)后感染并發(fā)癥的發(fā)生率和死亡率分別為38.5%和16.7%,均高于未輸血組的11.5%和3.8%(P<0.05); 術(shù)后抗生素應(yīng)用時間和住院時間分別為(9.7±4.2)d和(18.7±13.1)d,高于未輸血組的(5.3±2.3)d 和(12.7±5.2)d (P<0.001)。結(jié)論肝臟手術(shù)圍手術(shù)期輸血與術(shù)后感染并發(fā)癥發(fā)生有關(guān)。采取有效措施控制肝臟手術(shù)中失血量和/或減少輸血量可能有助于降低術(shù)后感染并發(fā)癥的發(fā)生率和死亡率。

引用本文: 蒲青凡,嚴(yán)律南,孫碎康,張川蓉,曹高健,戴華衛(wèi),陳展偉,李榮祥. 圍手術(shù)期輸血與肝臟術(shù)后感染并發(fā)癥的關(guān)系. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(2): 144-146. doi: 復(fù)制

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  2. 2. Opelz G, Graver B, Terasaki PI. Induction of high kidney survival rate by multiple transfusion [J]. Lancet, 1981; 1(8232)∶1223.
  3. 3. 李蔭山,朱善德,杜曉炬,等. 全肝血流阻斷無血切肝技術(shù)的臨床應(yīng)用 [J].中國普外基礎(chǔ)與臨床雜志, 1999; 6(4)∶243.
  4. 4. 嚴(yán)律南. 體外靜脈轉(zhuǎn)流下的肝葉切除術(shù) [J].中國普外基礎(chǔ)與臨床雜志,1999; 6(4)∶238.
  5. 5. Huguet C, Gallot D, Offenstadt G. Letter: Normothermic complete hepatic vascular exclusion for extensive resection of the liver [J]. N Engl J Med, 1976; 294(1)∶51.
  6. 6. Huguet C, Gavelli A, Chieco PA, et al. Liver ischemia for hepatic resection: where is the limit? [J]. Surgery, 1992; 111(3)∶251.
  7. 7. Nagasue N, Hayashi T, Uchida M. Techniques of hepatectomy for hepatocellular carcinoma [J]. Dig Surg, 1995; 12(1)∶34.
  8. 8. 嚴(yán)律南,曾勇,林琦遠,等. 半肝血流阻斷下肝能量代謝變化的研究 [J].中華肝膽外科雜志,2000; 6(1)∶10.
  9. 9. 嚴(yán)律南. 肝門板及其在肝膽外科的應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志,1998; 5(4)∶239.
  10. 10. Jones RM,Moulton CE,Hardy KJ.Central venous pressure and its effect on blood loss during liver resection [J].Br J Surg, 1998; 85(5)∶1058.