Wobbes T, Bemelmans B L, Kuypers J H, Beerthuizen G I, Theeuwes A G
Department of General Surgery, University Hospital Nijmegen, The Netherlands.
Surg Gynecol Obstet. 1990 Jul;171(1):59-62.
A group of 548 patients was analyzed retrospectively to determine risk factors, particularly the perioperative administration of blood, for postoperative septic complications after intra-abdominal operations. Of the entire group, 198 (36.1 per cent) had at least one complication. The postoperative mortality rate was 0.9 per cent. Using univariate analysis, blood transfusion, serum protein concentration, gastric malignant disease, total gastrectomy, anastomotic dehiscence, diabetes mellitus, the surgeon and perioperative antibiotics were significant factors influencing the rate of postoperative septic complications. After adjustment for all these factors, logistic regression analysis was used to study the effect of perioperative blood transfusion. Age, serum protein concentration, antibiotics, extended malignant disease of the colon, gastric operation, total colectomy, operation performed by staff members and anastomotic dehiscence were significant independent factors. Blood transfusion per se was not significant (p = 0.07). In patients who received more than 3 units of blood, the postoperative septic complication rate was significantly elevated (p = 0.003). We conclude that the perioperative administration of blood may negatively influence the risk of developing postoperative septic complications after intra-abdominal operations.
对一组548例患者进行回顾性分析,以确定腹内手术后发生术后感染性并发症的危险因素,尤其是围手术期输血情况。在整个组中,198例(36.1%)至少发生了一种并发症。术后死亡率为0.9%。采用单因素分析,输血、血清蛋白浓度、胃恶性疾病、全胃切除术、吻合口裂开、糖尿病、外科医生和围手术期使用抗生素是影响术后感染性并发症发生率的重要因素。在对所有这些因素进行调整后,采用逻辑回归分析来研究围手术期输血的影响。年龄、血清蛋白浓度、抗生素、结肠广泛恶性疾病、胃部手术、全结肠切除术、由工作人员实施的手术和吻合口裂开是重要的独立因素。输血本身并不显著(p = 0.07)。在接受超过3单位血液的患者中,术后感染性并发症发生率显著升高(p = 0.003)。我们得出结论,围手术期输血可能对腹内手术后发生术后感染性并发症的风险产生负面影响。