单纯冠状动脉旁路移植术患者围术期输血的危险因素分析

目的分析影响单纯冠状动脉旁路移植术(CABG)患者围术期血制品使用的危险因素。方法回顾性分析行单纯CABG的4 022名患者围术期使用血制品的情况,单因素及多元Logistic回归分析影响CABG患者血制品使用的相关因素。结果 65.74%(2 644/4 022)的单纯CABG患者在围术期使用过血制品,包括红细胞、血浆、血小板。输血与未输血患者的院内死亡率及并发症发生率比较:未输血组分别为0.00%(0/1 378)、12.84%(177/1 378),输血组分别为0.98%(26/2 644)、26.06%(689/2 644)(P0.01)。Logistic回归多因素分析:性别、年龄、BMI、吸烟史、糖尿病史、病变冠脉数量、术者经验、体外循环、术前波立维使用为CABG患者围术期血制品使用的独立危险因素。结论掌握影响CABG患者围术期使用血制品的危险因素,利于合理、有效的输血治疗。

Predictors of perioperative blood transfusion after coronary artery bypass grafting

Objective To analyze the predictors of perioperative blood transfusion after isolated coronary artery bypass grafting(CABG).Methods 4 022 consecutive patients undergoing isolated CABG were analyzed retrospectively.Univariate and multivariate logistic regression analyses were performed to investigate the predictors of perioperative blood transfusion.Results Blood products including red blood cells,plasma,platelets,were transfused to 65.74 %(2 644/4 022) of patients.No patients died in the none-transfused group and the morbidity was 12.84 percent,while the mortality and morbidity of transfused group were 0.98 %(26/2 644) and 26.06 %(689/2 644) respectively.Multivariate logistic regression revealed that gender,age,BMI,smoking,diabetes,lesion coronary number,operator experience,extracorporeal circulation,preoperative use of clopidogrel were independent predictors of perioperative blood transfusion.Conclusion It is economical and effective to have the knowledge of the risk factors for perioperative blood transfusion.