肝移植患者围手术期输血治疗及评估.docVIP

肝移植患者围手术期输血治疗及评估 　 作者：王宝燕，张建耕，宋昕梅，张文利 【关键词】 肝移植 　comEvaluation of perioperation blood component transfusion therapy in liver transplantation 【Abstract】 AIM： To investigate the perioperation blood component transfusion therapy and to summarize the experience of blood protection. METHODS: Eighty patients with liver transplantation were divided into 5 groups according to basic diseases and compared in the variety of blood routine and coagulation index for evaluating the effect of different basic diseases on blood component transfusion during operation. RESULTS: The levels of haemoglobin, platelet count and coagulation index were not statistically different between the 5 groups. The amount of transfused red blood cells and plasma in hepatitis B combined with primary liver cirrhosis group was higher than that in other groups （Plt;0.05）. The amount of platelet and whole blood transfusion had no statistical difference among various basic diseases. The total amount of blood transfusion could be decreased by use of blood conservation measures. CONCLUSION: Transfusion with appropriate components according to the patents disease conditions, taking corresponding blood conservation during the different periods, and monitoring the coagulation function can effectively reduce the amount of blood transfusion and enhance the success rate of liver transplantation. 【Keywords】 liver disease； liver transplantation； blood transfusion 【摘要】 目的：探讨肝移植患者手术期成分输血及血液保护的经验. 方法：所有肝移植患者依据基础疾病分为五组，比较不同基础疾病组之间血常规及凝血指标的变化差异，评估不同基础疾病对术中血液成分输注的影响. 结果：不同基础疾病组患者术前血红蛋白水平、血小板计数和凝血指标，各组间比较无统计学差异；乙肝合并肝硬化组患者的红细胞输注量及血浆用量明显增多，与其他组间比较有统计学差异（Plt;0.05）；不同基础疾病对血小板和全血的输注量无明显影响. 应用血液保护措施，可减少肝移植患者围手术期的输血总量. 结论：应根据患者的病情在不同时期选择适当的血液制剂输注，合理应用相应的血液保护措施，并对凝血功能动态检测，恰当纠正，可有效降低输血总量，有利于提高肝移植患者的存活率. 【关键词】 肝脏疾病；肝移植；输血 0引言 对于各种病因导致的终末期肝病患者，及时实施肝移植是挽救生命的唯一有效的治疗方法. 而且，肝移植也已成为治疗原发性肝癌的一种有效手段. 作为外科大型手术，肝移植需要大量输血及各种血液制品的输注. 由于输血还存在传播疾病的风险，因此，合理有效的输血治疗对肝移植手术的成功及患者预后显得更为重要. 我们通过分析肝移植病例的临床资料，评估肝移植患者的基础疾病对围手术期输血的影响及患者输血治疗的对策. 1对象和方法