Yamaguchi K, Tokui N, Maeda S, Kominami T, Nakamura K, Kitamura K
Department of Surgery, Shinkokura Hospital, Kitakyushu, Japan.
Aust N Z J Surg. 1990 Oct;60(10):765-72. doi: 10.1111/j.1445-2197.1990.tb07471.x.
The use of perioperative blood transfusion (PBT), the immunological status pre-operatively and at discharge from hospital, and the clinical course were examined retrospectively in 124 patients who underwent 'curative' resection for gastric cancer at Shinkokura Hospital, Japan from 1979 to 1988. The general condition of patients with PBT was worse than that of those without PBT and the pre-operative immunological status of patients with PBT was less favourable than that of those without PBT. At the time of discharge from hospital the immunological condition remained worse for patients who had been given PBT. The clinical course of patients with PBT was significantly worse. A dose-response relationship was evident but the types of blood products did not influence the outcome. Cox regression analysis adjusting for potentially confounding prognostic factors revealed that the clinical course was not altered by perioperative blood transfusion itself. These observations do not support the idea of adverse effects of perioperative blood transfusion on outcome of patients undergoing 'curative' resection for gastric cancer.
对1979年至1988年期间在日本新小仓医院接受胃癌“根治性”切除手术的124例患者进行回顾性研究，分析围手术期输血（PBT）的使用情况、术前及出院时的免疫状态以及临床病程。接受PBT的患者一般状况比未接受PBT的患者差，且接受PBT患者的术前免疫状态不如未接受PBT的患者。出院时，接受PBT的患者免疫状况仍然较差。接受PBT患者的临床病程明显更差。存在剂量反应关系，但血液制品类型不影响结果。对潜在混杂预后因素进行校正的Cox回归分析显示，围手术期输血本身并未改变临床病程。这些观察结果不支持围手术期输血对接受胃癌“根治性”切除患者的预后有不良影响这一观点。
