输血对脑外伤患者术后感染的影响

目的 探讨输血对脑外伤患者术后感染的影响，指导合理输血。方法 选择本院1997年1月~2004年1月525例脑外伤手术患者，其中225例术中输注普通悬浮红细胞，202例输注悬浮去白细胞红细胞，98例未输血。对3组患者术后感染率及输血剂量与感染率的关系进行比较。结果 普通悬浮红细胞输血组术后感染率为11．11％，悬浮去白细胞红细胞输血组术后感染率为3．46％，与普通悬浮红细胞输血组相比差异有显著性（P〈0．01），与未输血组感染率（2．04％）比较差异无显著性。普通悬浮红细胞输血组患者的输血量与术后感染的发生显著相关（P〈0．01），而悬浮去白细胞红细胞输血组的输血量与术后感染率的相关性不显著。结论 脑外伤患者术后感染的发生与输血、血液成分及输血量等有关。在保证患者能够耐受手术的情况下，应尽量不输血或少输血，对确需输血的患者，应该输注去白细胞红细胞。

The Effect of Blood Transfusion on Postoperative Infection in Patients with Cerebral Injury

Objective To investigate the effect of blood transfusion on postoperative infection in patients with cerebral injury,and to guide reasonable blood transfusion.Methods The patients who underwent operations in our hospital from 1997.1 to 2004.11 were observed.Among them,225 patients were transfused with red blood cell(RBC) concentrates suspension,202 with leucodepleted red cell concentrate(LDRC) suspension,98 were not transfused.The rate of postoperative infection of three groups and the correlation to the amount of transfusion were compared.Results The rate of postoperative infection of the group transfused with RBC concentrates suspension was 11.11%.The rate of postoperative infection of the group transfused with LDRC suspension was 3.46%,which was significantly different from that of the group transfused with RBC concentrates suspension(P<0.0l),but was not significantly different from that of the group without transfusion.The rate of postoperative infection was closed correlated to the amount of transfusion in the group transfused with RBC concentrates suspension (P<0.0l),while the rate of infection was not correlated to the amount of transfusion in the other group.Conclusions In patients with cerebral injury,the rate of postoperative infection was correlated to blood transfusion,blood composition and the amount of transfusion.So if the patients can resist operation,the blood should not be transfused or transfused as little as possible.If the blood must be transfused,the leukocytes should be removed from blood by filtration.