自体输血在妇科肿瘤患者手术中的应用分析*

doi:10.3969/j.issn.1671-2587.2021.03.006

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (3): 314-318.DOI: 10.3969/j.issn.1671-2587.2021.03.006

自体输血在妇科肿瘤患者手术中的应用分析^*

覃予思, 李元波, 薛颖泓, 姜衡春, 郑泽斌, 陈铃

530021 广西南宁,广西医科大学附属肿瘤医院输血科

收稿日期:2021-01-28 出版日期:2021-06-20 发布日期:2021-06-22
通讯作者: 陈铃,女,主任技师,硕士,长期从事临床输血管理及血液免疫学研究,（E-mail）chenling1964@126.com。
作者简介:覃予思（1994-）,女,住院医师,学士,主要从事肿瘤输血检验方面研究,（E-mail）513730228@qq.com。
基金资助:
* 本课题受广西自然科学基金（No.2019GXNSFDA245001）资助

Analysis of the Application of Autotransfusion in the Operation of Gynecological Tumor Patients

QIN Yu-si, LI Yuan-bo, XUE Ying-hong, et al

Department of Blood Transfusion, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530021

Received:2021-01-28 Online:2021-06-20 Published:2021-06-22

摘要/Abstract

摘要： 目的探讨自体输血在妇科肿瘤患者手术中的应用及效果。方法对432例手术的妇科肿瘤患者输血情况进行回顾性分析,其中分别选取宫颈癌和卵巢肿瘤患者,并分为观察组（输注自体血）和对照组（输注异体血）,对比两组免疫和血液学指标变化情况。结果 ①432例手术患者术后诊断中,宫颈癌占40%,卵巢肿瘤占30%,其它妇科肿瘤占30%,用血量1 325.5 U。其中199例术前采集自体血295U,自体输血率22.26%。②宫颈癌患者免疫方面观察组术后IgG明显降低（P<0. 05）;组间对比,对照组CD4⁺/CD8⁺降低更显著（P<0. 05）。血液学方面观察组术后TT明显延长（P<0. 05）。③卵巢肿瘤患者观察组IgM、IgG、IgA明显降低（P<0. 05）。结论两种输血方法在短期内对妇科肿瘤患者免疫和血液功能的影响无显著差异,且回输自体血的患者不会因采血后循环血容量减少而导致指标异常。

关键词: 恶性肿瘤, 自体输血, 异体输血, 择期手术, 输血效果

Abstract: Objective To explore the application and effect of autotransfusion in patients with gynecological tumor surgery. Methods A retrospective analysis of blood transfusion in 432 gynecological tumor patients undergoing surgery was conducted. Patients with cervical cancer and ovarian tumor were selected and divided into observation group (autologous blood transfusion) and control group (allogeneic blood transfusion). The changes of immunological and hematological indexes were compared between the two groups. Results ①Among the 432 patients diagnosed after operation, cervical cancer accounted for 40%, ovarian tumors accounted for 30%, other gynecological tumors accounted for 30%, and the blood consumption was 1 325.5 U. In 199 cases, 295 U of autologous blood was collected preoperatively, and the rate of autologous blood transfusion was 22.26%. ②In the aspect of immunity, IgG in observation group was significantly decreased after operation in patients with cervical cancer (P<0.05). Comparison between groups, CD4⁺/CD8⁺ ratio of T lymphocytesdecreased significantly in control group (P<0.05). In hematology, TT was significantly prolonged in the observation group (P<0.05). ③In ovarian tumor patients, IgM, IgG and IgA in observation group were significantly decreased (P<0.05). Conclusion There was no significant difference in the effect of the two transfusion methods on the immunological and hematological function of gynecological tumor patients in the short term. The indexes of patients with autologous blood transfusion would not be abnormal due to the decrease of circulating blood volume after blood collection.

Key words: Malignant tumor, Autotransfusion, Allogenetic transfusion, Elective surgery, Effect of blood transfusion

中图分类号:

R457.1

覃予思, 李元波, 薛颖泓, 姜衡春, 郑泽斌, 陈铃. 自体输血在妇科肿瘤患者手术中的应用分析^*[J]. 临床输血与检验, 2021, 23(3): 314-318.

QIN Yu-si, LI Yuan-bo, XUE Ying-hong, et al. Analysis of the Application of Autotransfusion in the Operation of Gynecological Tumor Patients[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(3): 314-318.

参考文献

[1] 张秀英,颜东.某医院自体输管理血的现状及对策[J].世界最新医学信息文摘,2018,18(55):270.
[2] 李小薇,范秀,刘娟,等.本院储存式自体输血的临床应用及问题分析[J].中国输血杂志,2017,30(9):1027-1030.
[3] 卫生部.临床输血技术规范[S].2000.
[4] 中国输血协会临床输血专业委员会.自体输血临床路径管理专家共识(2019)[J].临床血液学杂志,2019,32(2):81-86.
[5] ZHANG Y,ZHANG X S,ZHAO S P,et al.Stored autologous blood transfusion does not increase recurrence of prostate cancer after radical prostatectomy:a preliminary study[J].Zhonghua Nan Ke Xue,2019,25(5):430-433.
[6] HUANG H Y,HUNAG J Y,WEI Y M,et al.Clinical application of preoperative autologous blood donation in selective general surgery[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2020,28(3):967-971.
[7] HENDERSON R A,JUDD M,STRAUSS E R,et al.Hematologic evaluation of intraoperative autologous blood collection and allogeneic transfusion in cardiac surgery[J].Transfusion,2021,61(3):788-798.
[8] 李红霞,韩志强,钟海燕.回收式自体输血对肿瘤手术患者预后的影响[J].临床输血与检验,2018,20(1):106-108.
[9] ZDRAVKOVIC D,BILANOVIC D,RANDJELOVIC T,et al.Allogeneic blood transfusion in patients in Dukes B stage of colorectal cancer[J].Med Oncol,2011,28(1):170-174.
[10] 陈真,刘媛媛,谢新平,等.妇科肿瘤患者不同状态下的免疫功能评价[J].现代肿瘤医学,2015,23(24):3638-3642.
[11] 吴敏,龙静,杨瑶.自体输血与异体输血对择期手术患者凝血功能及免疫功能的影响[J].河北医学,2017,23(7):1170-1174.
[12] 樊文娜,符琼月,曾丽芬.自体血回输对多脏器损伤患者血液流变学、免疫功能及炎性因子的影响[J].临床血液学杂志,2019,32(8):579-582.
[13] 夏敏,王凌,周旺辉,等.自体血液回输对全麻手术患者免疫状态及感染的影响研究[J].中华医院感染学杂志,2017,27(5):1066-1069.
[14] 梁金凤,韦赐秋.恶性肿瘤患者输血与复发相关性的研究进展[J].国际检验医学杂志,2018,39(12):1498-1501.
[15] 罗云,汪宏梅.自体及异体输血对胃癌根治术患者炎性因子及免疫功能的影响[J].中外医疗,2016,35(4):106-107.
[16] 张春丽,张改英,田慧芳.围术期胃肠道恶性肿瘤患者自体输血对凝血功能和血清炎性因子水平的影响[J].检验医学与临床,2016,13(23):3342-3344.
[17] 邹宏坤.异体输血对恶性肿瘤患者免疫功能的影响[J].中国城乡企业卫生,2014,29(1):66-69.
[18] 施蔚.储存式自体输血在临床的应用分析[J].中国卫生标准管理,2018,9(3):134-135.
[19] 陆少燕,胡恩聪,高家良,等.自体输血及异体输血对骨伤科患者术后感染的影响比较[J].中国乡村医药,2019,26(24):3-4.
[20] 谢琦,林舟丹,张新华,等.等容稀释性自体输血对骨科老年手术病人凝血和免疫功能的影响[J].实用老年医学,2018,32(2):134-136.
[21] ARAUJO R L,PANTANALI C A,HADDAD L,et al.Does autologous blood transfusion during liver transplantation for hepatocellular carcinoma increase risk of recurrence?[J].World J Gastrointest Surg,2016,8(2):161-168.
[22] KANG R,SEATH B E,HUANG V,et al.Impact of autologous blood transfusion on survival and recurrence among patients undergoing partial hepatectomy for colorectal cancer liver metastases[J].J Am Coll Surg,2019,228(6):902-908.
[23] LI S L,YE Y,YUAN X H.Association between allogeneic or autologous blood transfusion and survival in patients after radical prostatectomy:a systematic review and meta-analysis[J].PLoS One,2017,12(1):e0171081.
[24] LIM M H,JE H G,JU M H,et al.Effects of preoperative autologous blood donation in patients undergoing minimally invasive cardiac surgery[J].Korean J Thorac Cardiovasc Surg,2019,52(6):385-391.

自体输血在妇科肿瘤患者手术中的应用分析^*

Analysis of the Application of Autotransfusion in the Operation of Gynecological Tumor Patients

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

关于本刊

作者中心

在线期刊

访问统计

联系我们

[1]	汪晓晓, 郭建荣. 自体输血在老年患者手术中的应用价值及风险分析^*[J]. 临床输血与检验, 2021, 23(2): 259-262.
[2]	钟明璐, 黄慧瑛, 张旸, 王立, 汪传喜, 魏亚明. 储存式自体输血在脊柱外科手术中应用的疗效及安全性研究^*[J]. 临床输血与检验, 2021, 23(1): 68-71.
[3]	王瑞含, 范金波, 周国均, 刘久波. 回收式自体输血对剖宫产妇异体输血及经济效益的影响^*[J]. 临床输血与检验, 2020, 22(5): 487-492.
[4]	周文玲, 杨融辉, 金晶纯, 肇硕, 郝一文. 围手术期患者血液管理对手术用血量影响作用的分析[J]. 临床输血与检验, 2020, 22(5): 501-506.
[5]	王瑞含, 范金波, 周国均, 刘久波. 回收式自体输血在某院剖宫产手术中的应用分析[J]. 临床输血与检验, 2020, 22(4): 380-383.
[6]	赵刚, 郭凡, 李君, 李清. 低效价红细胞血型抗体对新疆地区肿瘤患者输血效果的影响[J]. 临床输血与检验, 2020, 22(4): 383-386.
[7]	连萍红, 陈丰梅, 彭红. 贮存式自体输血对非停跳冠状动脉旁路移植术患者免疫功能及术后恢复的影响[J]. 临床输血与检验, 2020, 22(4): 390-393.
[8]	孙小媛, 徐文莹, 王海燕. 妊娠晚期孕妇自体全血保存期间血液质量变化[J]. 临床输血与检验, 2020, 22(3): 264-268.
[9]	王瑞含, 范金波, 周国均, 褚笑眉, 韩小玮, 刘久波. 术中回收式自体输血对剖宫产产妇肝功能指标和血浆蛋白的影响[J]. 临床输血与检验, 2020, 22(1): 9-13.
[10]	王彦, 杨璐, 潘纪春. 深度自体储血在骨科关节置换术中的应用价值研究[J]. 临床输血与检验, 2019, 21(5): 462-464.
[11]	黄家福, 张晓琳, 陈宝婷, 吴耀建. 贮存式自体血在老年患者中的应用分析[J]. 临床输血与检验, 2019, 21(5): 477-479.
[12]	马春娅, 孙晓琳, 封彦楠, 张晓娟, 姜旭, 于洋, 汪德清. 造血干细胞移植患者红细胞输血效果的影响因素分析^*[J]. 临床输血与检验, 2019, 21(4): 341-344.
[13]	周循, 刘小倩, 朱娜娜, 郭建荣. 输血与造血干细胞相关的研究进展^*[J]. 临床输血与检验, 2019, 21(3): 330-332.
[14]	刘小倩, 周循, 朱娜娜, 周伟标, 夏荣, 郭建荣. 上海市浦东新区围术期临床用血情况调查^*[J]. 临床输血与检验, 2018, 20(5): 449-452.
[15]	刘丹薇,王苏建. 临床内科患者连续输血后的效果分析[J]. 临床输血与检验, 2018, 20(4): 362-364.