预防性输注新鲜冰冻血浆对胰十二指肠切除术患者的近期疗效观察

目的探讨胰十二指肠切除术患者术后预防性输注新鲜冰冻血浆的临床疗效。方法回顾性分析中南大学湘雅三医院2015年1月至2018年12月收治的112例接受十二指肠切除术治疗的胰腺恶性肿瘤患者,根据术后6 h是否预防性输注新鲜冰冻血浆(FFP)分为对照组65例和FFP组47例。比较2组患者术后3 d平均生命体征和凝血指标及患者术后肛门排气时间、首次进流食时间、72 h伤口引流量、术后拔除引流管时间、术后住院天数、围手术期费用和术后并发症发生率。结果FFP组患者术后血白蛋白浓度显著高于对照组(36.7±1.4)g/L vs(33.2±1.0)g/L,t=15.109,P<0.001],术后72 h伤口引流量、术后拔除引流管时间、术后住院天数、围手术期费用、总并发症发生率均小于对照组(131.1±54.6)ml vs(212.0±67.8)ml,t=-6.749,P<0.001;(6.0±1.3)d vs(9.0±1.6)d,t=-10.81,P<0.001;(14.1±1.8)d vs(18.9±3.6)d,t=-9.334,P<0.001;(89531.0±7789.4)元vs(105743.3±7440.8)元,t=-11.16,P<0.001;10.6%(5/47)vs 36.9%(24/65),χ~2=9.821,P=0.002]。2组患者术后均未出现围手术期死亡,FFP组患者未出现输血相关并发症。结论胰十二指肠切除术患者术后预防性输注FFP,具有使患者术后出血少、恢复快、缩短住院时间、减少住院费用和降低并发症发生率等优点,对患者近期临床效果显著。

Short-term efficacy of prophylactic infusion of fresh frozen plasma in patients undergoing pancreaticoduodenectomy

ObjectiveTo evaluate the clinical efficacy of postoperative prophylactic infusion of fresh frozen plasma in patients undergoing pancreaticoduodenectomy (PD). MethodsA retrospective analysis was performed on 112 patients with pancreatic malignancies treated by PD at the Third Xiangya Hospital from January 2015 to February 2018. According to whether postoperative 6 h prophylactic infusion of fresh frozen plasma (FFP) was administered or not, the patients were divided into either a control group (n=65 cases) or on FFP group (n=47 cases). The 3-day average vital signs, coagulation parameters, 72-hour postoperative wound drainage, time to anal exhaust, time to first intake, time to postoperative drainage tube removal, postoperative hospital stay, perioperative cost and surgery were compared between the two groups. The incidence of postoperative complications was also compared. ResultsThe serum albumin concentration of patients in the FFP group was significantly higher than that in the control group (36.7±1.4) g/L vs (33.2±1.0) g/L, t=15.109, P<0.001], while the 72-hour postoperative wound drainage, time to postoperative drainage tube removal time, postoperative hospital stay, perioperative cost, and total complication rate were all smaller than those in the control group (131.1±54.6) ml vs (212.0 ±67.8) ml, t=-6.749, P<0.001; (6.0±1.3) d vs (9.0±1.6) d, t=-10.81, P<0.001; (14.1±1.8) d vs (18.9±3.6) d, t=-9.334, P<0.001; (89 531.0±7789.4) yuan vs (105 743.3±7440.8) yuan, t=-11.16, P<0.001); 10.6% (5/47) vs 36.9% (24/65), χ²=9.821, P=0.002]. There were no perioperative deaths between in either group. There was no blood transfusion-related complications occurred in the plasma group. ConclusionProphylactic infusion of FFP in patients undergoing PD has the advantages of less postoperative bleeding, faster recovery, shorter hospital stay, reduced hospitalization costs, and reduced incidence of complications.