肝癌手术中自体输血的优势。
Advantage of autologous blood transfusion in surgery for hepatocellular carcinoma.
机构信息
Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan.
出版信息
World J Gastroenterol. 2011 Aug 28;17(32):3709-15. doi: 10.3748/wjg.v17.i32.3709.
AIM
To evaluate the significance of autologous blood transfusion (AT) in reducing homologous blood transfusion (HT) in surgery for hepatocellular carcinoma (HCC).
METHODS
The proportion of patients who received HT was compared between two groups determined by the time of AT introduction; period A (1991-1994, n = 93) and period B (1995-2000, n = 201). Multivariate logistic regression analysis was performed in order to identify independent significant predictors of the need for HT. We also investigated the impact of AT and HT on long-term postoperative outcome after curative surgery for HCC.
RESULTS
The proportion of patients with HT was significantly lower in period B than period A (18.9% vs 60.2%, P < 0.0001). Multivariate logistic regression analysis identified AT administration as a significant independent predictor of the need for HT (P < 0.0001). Disease-free survival in patients with AT was comparable to that without any transfusion. Multivariate analysis identified HT administration as an independent significant factor for poorer disease-free survival (P = 0.0380).
CONCLUSION
AT administration significantly decreased the need for HT. Considering the postoperative survival disadvantage of HT, AT administration could improve the long-term outcome of HCC patients.
目的
评估自体输血（AT）在减少肝细胞癌（HCC）手术中同种异体输血（HT）的意义。
方法
通过 AT 引入时间将两组患者的 HT 接受比例进行比较；A 期（1991-1994 年，n=93）和 B 期（1995-2000 年，n=201）。为了确定 HT 需求的独立显著预测因素，进行了多变量逻辑回归分析。我们还研究了 AT 和 HT 对 HCC 根治性手术后长期术后结果的影响。
结果
B 期 HT 接受比例明显低于 A 期（18.9% vs 60.2%，P<0.0001）。多变量逻辑回归分析确定 AT 给药是 HT 需求的显著独立预测因素（P<0.0001）。接受 AT 的患者无病生存率与未接受任何输血的患者相当。多因素分析确定 HT 给药是无病生存率较差的独立显著因素（P=0.0380）。
结论
AT 给药显著降低了 HT 的需求。考虑到 HT 的术后生存劣势，AT 给药可以改善 HCC 患者的长期预后。
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