100例肝移植患者围手术期输血疗效分析

目的分析成分输血在100例肝移植围手术期的疗效,及时有效调控患者止、凝血功能,降低围手术期并发症发生率、提高肝移植成功率,提出科学、安全、合理用血是肝移植围手术期输血的指导原则。方法观察本院100例肝移植患者输血疗效,分析术前、术中和术后各期悬浮红细胞(R ccs)、新鲜冰冻血浆(FFP)、冰冻血小板(FPRP)、冷沉淀(Cryoprec ip itate,cryo)的输注,并对本院开展肝移植手术以来前50例和后50例输血情况进行比较。结果100例肝移植患者人均输血3,334 m l,术前占4.3%,术中53.4%,术后42.3%;围手术期成分输血率达100%,悬浮红细胞与新鲜冰冻血浆比例为1.45:1;前50例人均输血量和术后并发症发生率显著大于后50例,但术前输血率和悬浮红细胞输注比例有增加趋势。结论科学、安全、合理输血对肝移植成功率至关重要,明显降低肝移植术中、术后大出血和肝动脉门静脉血管吻合口血栓形成等并发症的发生率。

The curative effects of blood transfusion on 100 perioperative patients undergoing liver-transplantation

Objective To analyze the curative effect of blood transfusion on 100 patients undergoing liver transplantation,to efficiently enhance hemostasis and coagulation function of the patients,to lower the incidence of the operative complications,and to put forward the guideline of blood transfusion to the patients undergoing liver transplantation.Methods The volumes of red blood cells concentrates(RCCs),fresh frozen plasma(FFP),cryopreserved platelets,and cryoprecipitate transfused to the patients undergoing liver transplantation were measured before,during and after the operation respectively.The volumes of blood components transfused to the 50 patients in the former stage and 50 patients in the later stage of liver transplantation in our hospital were also measured respectively.Results The mean volume of the blood components transfused to each patient was 3 334ml.The ratios of the transfused blood volumes to 100 patients were 4.3%,53.4% and 42.3% before,during and after operation respectively.The rate of blood components transfusion was 100% and the ratio of transfused blood volumes to the patients between RCCs and FFP was 1.45:1.The mean volumes of the transfused blood and the operative complications of 50 patients in the former stage of liver transplantation of our hospital were significantly higher than those of the 50 patients in the later stage.Conclusion It is very vital in the scientific,safe and reasonable blood transfusion for the success of liver transplantation,which significantly lowers the incidence of operative complications,such as massive haemorrhage during and after operation,and thrombosis at inosculation of liver artery and portal vein.