预充用红细胞储存时间与体外循环心脏手术患儿术后肺炎发生风险的相关性研究

doi:10.3969/j.issn.1671-2587.2026.02.007

临床输血与检验 ›› 2026, Vol. 28 ›› Issue (2): 192-197.DOI: 10.3969/j.issn.1671-2587.2026.02.007

预充用红细胞储存时间与体外循环心脏手术患儿术后肺炎发生风险的相关性研究

付晓艳, 邱立娟, 甄自达, 牛子健, 马曙轩

国家儿童医学中心/首都医科大学附属北京儿童医院,北京 100045

收稿日期:2025-06-23 接受日期:2025-07-29 出版日期:2026-04-20 发布日期:2026-04-22
通讯作者: 马曙轩,主要从事儿科临床输血及儿童凝血功能研究,（E-mail）masxfwyy@sina.com。
作者简介:付晓艳,主要从事临床输血相关工作,（E-mail）646961901@qq.com。

The Association between the Erythrocyte Storage Duration and Postoperative Pneumonia Risk in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass

FU Xiaoyan, QIU Lijuan, ZHEN Zida, NIU Zijian, MA Shuxuan

Department of Blood Transfusion, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045

Received:2025-06-23 Accepted:2025-07-29 Online:2026-04-20 Published:2026-04-22

摘要/Abstract

摘要： 目的探讨预充用红细胞储存时间延长与体外循环（CPB）心脏手术患儿术后发生肺炎之间的关系。方法回顾性分析2022年1月—2024年7月于我院择期行CPB心脏手术的先天性心脏病患儿444例,入选患儿均根据CPB预充所用红细胞储存时间分为新鲜红细胞组（≤14日,n=214例）和陈旧红细胞组（15~35日,n=230例）。比较两组患儿术后肺炎发生和病原菌分布情况。结果在纳入的444例患儿中,35例术后合并肺炎,总发生率为7.89%。新鲜红细胞组患儿214例,术后11例（5.14%）发生肺炎;陈旧红细胞组患儿230例,术后24例（10.43%）发生肺炎。统计分析显示,与接受新鲜红细胞的患儿相比,接受陈旧红细胞患儿的术后肺炎发生率更高,差异有统计学意义（发生率χ²=4.242,P=0.039）。新鲜红细胞组肺炎患儿中感染病原菌分布情况为革兰阴性菌6例、革兰阳性菌3例,其他2例;陈旧红细胞组肺炎患儿中感染病原菌分布情况为革兰阴性菌13例、革兰阳性菌5例,其他6例。两组病原菌分布比较差异无统计学意义（P=0.907）。结论预充用红细胞储存时间延长可能增加体外循环心脏手术患儿术后肺炎发生风险,但不改变致病菌谱。

关键词: 红细胞储存时间, 体外循环, 术后肺炎, 小儿心脏外科

Abstract: Objective To investigate the association between the longer red blood cell (RBC) storage duration and postoperative pneumonia (POP) in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods A retrospective analysis of 444 children with congenital heart disease who underwent CPB cardiac surgery at our hospital from January 2022 to July 2024 was performed, and they were divided into fresh RBC group (storage duration≤14 d, n=214) and the older RBC group (storage duration with 14~35 d, n=230). The incidence and pathogen distribution of POP were compared between two groups. Results Among 444 enrolled patients, 35 developed POP (7.89%). In the fresh RBC group, 11 of 214 patients (5.14%) developed POP, compared to 24 of 230 patients (10.43%) in the older RBC group. Statistical analysis revealed a significantly higher incidence of POP in patients receiving older RBC versus fresh RBC (χ²=4.242, P=0.039). Pathogen distribution in POP cases of the new RBC group was Gram-negative bacteria (n=6), Gram-positive bacteria (n=3) and others (n=2). Pathogen distribution in POP cases of the older RBC blood group was Gram-negative bacteria (n=13), Gram-positive bacteria (n=5) and others (n=6). There was no significant difference in pathogen spectrum between two groups (P=0.907). Conclusion Prolonged storage duration of priming RBCs may increase the risk of POP in children undergoing CPB cardiac surgery without altering the pathogenic bacterial spectrum.

Key words: Red blood cell storage duration, Cardiopulmonary bypass, Postoperative pneumonia, Pediatric cardiac surgery

中图分类号:

R726

付晓艳, 邱立娟, 甄自达, 牛子健, 马曙轩. 预充用红细胞储存时间与体外循环心脏手术患儿术后肺炎发生风险的相关性研究[J]. 临床输血与检验, 2026, 28(2): 192-197.

FU Xiaoyan, QIU Lijuan, ZHEN Zida, NIU Zijian, MA Shuxuan. The Association between the Erythrocyte Storage Duration and Postoperative Pneumonia Risk in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2026, 28(2): 192-197.

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预充用红细胞储存时间与体外循环心脏手术患儿术后肺炎发生风险的相关性研究

The Association between the Erythrocyte Storage Duration and Postoperative Pneumonia Risk in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass

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