Titlestad I L, Ebbesen L S, Ainsworth A P, Lillevang S T, Qvist N, Georgsen J
Department of Clinical Immunology, Odense University Hospital, Denmark.
Int J Colorectal Dis. 2001 Jun;16(3):147-53. doi: 10.1007/s003840100298.
Allogeneic blood transfusions are claimed to be an independent risk factor for postoperative infections in open colorectal surgery due to immunomodulation. Leukocyte-depletion of erythrocyte suspensions has been shown in some open randomized studies to reduce the rate of postoperative infection to levels observed in nontransfused patients. Using a double-blinded, randomized design, we studied the postoperative infection rate in patients undergoing open colorectal surgery transfused with either leukocyte-depleted erythrocyte suspensions (LD-SAGM) or non-leukocyte-depleted erythrocyte suspensions (SAGM). Unselected patients (n 279) were allocated to receive LD-SAGM (n 139) or SAGM (n 140) if transfusion was indicated. Forty-five percent were transfused, yielding 48 patients in the LD-SAGM group and 64 in the SAGM group. Thirteen patients were excluded because they received one type of transfusion in spite of randomization to the other type. No significant differences in the rates of postoperative infections (P=0.5250) or postoperative complications (P=0.1779) were seen between the two transfused groups. Infection rates were 45% and 38% in the transfused groups and 21% and 23% in the nontransfused groups. No significant difference between the transfused groups was seen on any single infectious event, mortality rate, or duration of hospitalization. Leukocyte-depletion of erythrocyte suspensions transfused to patients undergoing open colorectal surgery does not reduce postoperative infection rates.
异体输血被认为是开放性结直肠手术术后感染的一个独立危险因素,原因是免疫调节作用。在一些开放性随机研究中,已表明对红细胞悬液进行白细胞去除可将术后感染率降低至未输血患者所观察到的水平。我们采用双盲、随机设计,研究了接受白细胞去除红细胞悬液(LD-SAGM)或未去除白细胞红细胞悬液(SAGM)输血的开放性结直肠手术患者的术后感染率。如果有输血指征,未经过筛选的患者(n = 279)被分配接受LD-SAGM(n = 139)或SAGM(n = 140)。45%的患者接受了输血,LD-SAGM组有48例患者,SAGM组有64例患者。13例患者被排除,因为尽管随机分配到另一组,但他们接受了一种类型的输血。两个输血组在术后感染率(P = 0.5250)或术后并发症(P = 0.1779)方面没有显著差异。输血组的感染率分别为45%和38%,未输血组分别为21%和23%。在任何单一感染事件、死亡率或住院时间方面,输血组之间均未观察到显著差异。对接受开放性结直肠手术的患者输注的红细胞悬液进行白细胞去除并不能降低术后感染率。