结直肠恶性肿瘤患者围手术期输血和术后感染并发症的相关性研究*

doi:10.3969/j.issn.1671-2587.2022.04.002

临床输血与检验 ›› 2022, Vol. 24 ›› Issue (4): 416-421.DOI: 10.3969/j.issn.1671-2587.2022.04.002

结直肠恶性肿瘤患者围手术期输血和术后感染并发症的相关性研究^*

周琳, 慈璇, 邵小宝, 王华, 杨圆, 高凤威, 朱培元

210022 南京中医药大学附属南京中医院输血科

收稿日期:2021-12-06 出版日期:2022-08-20 发布日期:2022-08-19
通讯作者: 朱培元,男,主任技师,硕士研究生导师,（E-mail）zhupy@njucm.edu.cn。
作者简介:周琳（1980-）,女,主管技师,本科,主要从事临床输血工作,（E-mail）1040737532@qq.com。并列第一作者：慈璇（1991-）,女,技师,本科,主要从事临床输血工作,（E-mail）510587291@qq.com。
基金资助:
*本课题受南京市科技计划项目（No.201715036）和南京市卫生科技发展专项资金项目（No.YKK21195）资助

Correlation between Perioperative Blood Transfusion and Postoperative Inflammatory Complications in Patients with Colorectal Cancer

ZHOU Lin, CI Xuan, SHAO Xiao-bao, et al

Department of Transfusion Medicine, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022

Received:2021-12-06 Online:2022-08-20 Published:2022-08-19

摘要/Abstract

摘要： 目的研究结直肠恶性肿瘤患者围手术期输血和术后感染并发症的相关性。方法收集2019年2月~2021年6月行结直肠肿瘤手术且病理确诊为恶性肿瘤的病例,对患者围手术期是否输血以及血液检测结果、改良的格拉斯哥预后评分（modified Glasgow Prognostic Score,mGPS)、手术方式、手术时间、肿瘤体积大小、肿瘤部位、TNM分期、住院天数、术后是否有感染并发症等进行分类统计分析。结果共643例患者符合纳入、排除标准,其中术前贫血201例（31.3%）,非贫血442例（68.7%）;围手术期输血156例（24.3%）,未输血487例（75.7%）;术后115例（17.9%）发生感染并发症。倾向评分匹配后对围手术期输血组（81例）和未输血组（81例）进行对照分析,结果输血组的感染并发症发生率显著高于未输血组（分别为32.1%、17.3%,P=0.029）,且中位住院天数更长（分别为23、20.5 d,P=0.008）;单因素logistic回归分析显示围手术期输血是术后感染并发症的独立危险因素（OR=2.262,95% CI 1.078~4.747,P=0.031）。结论在接受结直肠恶性肿瘤手术的患者中,围手术期输血与术后感染并发症相关。

关键词: 结直肠恶性肿瘤, 输血, 感染并发症, 贫血

Abstract: Objective To investigate relationships between perioperative blood transfusion and postoperative inflammatory complications in patients with colorectal cancer. Methods The patients who underwent colorectal cancer surgery and were pathologically diagnosed with malignant tumors between February 2019 and June 2021 were collected. The perioperative blood transfusion, hematological parameters, modified Glasgow Prognostic Score (mGPS), operation mode, operation time, tumor size, tumor location, TNM staging, hospital length of stay and postoperative inflammation were statistically analyzed.Results A total of 643 patients met the inclusion and exclusion criteria, including 201 cases of preoperative anemia (31.3%), 442 cases of non-anemia (68.7%), and 156 cases of perioperative blood transfusion (24.3%), 487 cases (75.7%) without blood transfusion, and inflammatory complications occurred in 115 cases (17.9%). After propensity score matching, the perioperative transfusion group (81 cases) and non-transfusion group (81 cases) were compared and analyzed. The results showed that the incidence of inflammatory complications in the perioperative transfusion group was significantly higher than that in the non-transfusion group (32.1% and 17.3%, respectively, P=0.029), The median hospital length of stay was longer (23 and 20.5 days, respectively, P=0.008). Univariate logistic regression analysis showed that perioperative blood transfusion was an independent risk factor for postoperative inflammatory complications (OR 2.262, 95% CI 1.078~4.747, P=0.031).Conclusion Perioperative blood transfusion is associated with postoperative inflammatory complications in patients undergoing colorectal cancer surgery.

Key words: Colorectal cancer, Transfusion, Inflammatory complication, Anemia

中图分类号:

R735.3
R457

周琳, 慈璇, 邵小宝, 王华, 杨圆, 高凤威, 朱培元. 结直肠恶性肿瘤患者围手术期输血和术后感染并发症的相关性研究^*[J]. 临床输血与检验, 2022, 24(4): 416-421.

ZHOU Lin, CI Xuan, SHAO Xiao-bao, et al. Correlation between Perioperative Blood Transfusion and Postoperative Inflammatory Complications in Patients with Colorectal Cancer[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2022, 24(4): 416-421.

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结直肠恶性肿瘤患者围手术期输血和术后感染并发症的相关性研究^*

Correlation between Perioperative Blood Transfusion and Postoperative Inflammatory Complications in Patients with Colorectal Cancer

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