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术后血小板计数低对术中未输注血小板的成人肝移植

王赛楠 吴志涛 吴延 吴安石

王赛楠, 吴志涛, 吴延, 等. 术后血小板计数低对术中未输注血小板的成人肝移植[J]. 器官移植, 2020, 11(3): 374-378. doi: 10.3969/j.issn.1674-7445.2020.03.009
引用本文: 王赛楠, 吴志涛, 吴延, 等. 术后血小板计数低对术中未输注血小板的成人肝移植[J]. 器官移植, 2020, 11(3): 374-378. doi: 10.3969/j.issn.1674-7445.2020.03.009
Wang Sainan, Wu Zhitao, Wu Yan, et al. Effect of low postoperative platelet count on early fatality rate of adult liver transplantation without platelet transfusion during operation[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 374-378. doi: 10.3969/j.issn.1674-7445.2020.03.009
Citation: Wang Sainan, Wu Zhitao, Wu Yan, et al. Effect of low postoperative platelet count on early fatality rate of adult liver transplantation without platelet transfusion during operation[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 374-378. doi: 10.3969/j.issn.1674-7445.2020.03.009

术后血小板计数低对术中未输注血小板的成人肝移植

doi: 10.3969/j.issn.1674-7445.2020.03.009
基金项目: 

北京市医院管理局重点医学培育项目 ZYLX201822

详细信息
    作者简介:

    王赛楠,女,1988年生,硕士,住院医师,研究方向为肝移植麻醉和血液保护,Email:sunnywsn915@163.com

    通讯作者:

    吴延,男,1969年生,博士,主任医师,研究方向为心胸与器官移植手术麻醉学,Email:wuyan@bjcyh.com

    吴安石,男,1965年生,博士,博士研究生导师,主任医师,研究方向为器官移植和心胸外科麻醉与器官保护,Email:wuanshi88@163.com

  • 中图分类号: R617

Effect of low postoperative platelet count on early fatality rate of adult liver transplantation without platelet transfusion during operation

More Information
  • 摘要:   目的  探讨在肝移植受者术中未输注血小板(PLT)的情况下,术后早期PLT计数低对受者早期病死率的影响。  方法  回顾性分析接受同种异体原位肝移植的180例受者临床资料。采用受试者工作特征(ROC)曲线计算术后7 d PLT计数预测术后早期病死率的临界值。根据临界值将受者分为低PLT计数组和对照组。纳入肝移植受者的相关临床资料,包括围手术期PLT计数、术前一般情况、术中情况。采用Logistic回归分析影响肝移植受者术后早期病死率的独立危险因素。观察并比较两组肝移植受者的早期预后情况,包括术后重症监护室(ICU)住院时间、术后住院时间、初期移植肝功能异常率、术后30 d病死率。  结果  术后7 d PLT计数 < 32×109/L是肝移植受者术后30 d病死率的独立危险因素(P < 0.05)。低PLT计数组受者的术后ICU住院时间为9(5,14)d,明显长于对照组受者的5(3,6)d(P < 0.05);初期移植肝功能异常率为55.0%,明显高于对照组受者的20.6%(P < 0.05);术后30 d病死率为40.0%,明显高于对照组受者的2.5%(P < 0.05)。两组受者间的术后住院时间差异无统计学意义(P > 0.05)。  结论  术后7 d PLT计数 < 32×109/L是肝移植受者术后30 d病死率的独立危险因素,其可以提示术后初期移植肝功能异常,辅助预测肝移植受者早期预后。

     

  • 表  1  肝移植受者早期病死率的影响因素分析

    Table  1.   Analysis of influencing factors on early mortality of liver transplant recipient

    变量 多因素分析
    OR 95%CI P
    MELD评分 1.066 0.991~1.148 0.088
    手术时间 1.002 0.996~1.008 0.584
    失血量 0.990 0.968~1.103 0.391
    术前PLT计数 < 32×109/L 0.577 0.090~3.678 0.561
    术后7 d PLT计数 < 32×109/L 31.434 6.996~141.230 0.000
    注:①OR为比值比。
    CI为可信区间。
    下载: 导出CSV
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  • 收稿日期:  2020-02-27
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-05-15

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