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[早期宫颈癌患者术中失血的相关危险因素]

[Risk Factors Associated with Intraoperative Blood Loss in Patients with Early Cervical Cancer].

作者信息

Wang Hui, He Quan-Jiang, Han Ling, Cheng Ya-Li, Bai Li-Ping, Mo Xiao-Yu, Tang Hui-Yu, Zheng Ai

机构信息

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) , Ministry of Education, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2019 Jan;50(1):115-118.

Abstract

OBJECTIVE

To determine risk factors associated with intraoperative blood loss in patients with early cervical cancer (stage ⅠB-ⅡA).

METHODS

The medical records of 892 patients who underwent surgical treatments for early cervical cancer in the Second West China University Hospital of from Dec 2010 to Sep 2017 were retrospectively reviewed: 127 having ≥500 mL intraoperative blood loss patients compared with 765 less than 500 mL. Differences between the two groups in age, body mass index (BMI), gravidity, history of abdominal and pelvic operations, chronic pelvic inflammation disease, clinical stage, methods of operation, neoadjuvant chemotherapy (NACT) and post-NACT operative opportunity, preoperative and postoperative hemoglobin, and intraoperative transfusion volume were analyzed through univariate and multivariate statistical methods.

RESULTS

The univariate analyses identified age, BMI, gravidity, history of abdominal and pelvic operation, chronic pelvic inflammation disease, clinical stage, methods of operation, NACT and post-NACT operative opportunity assignificant factors associated with intraoperative blood loss ( <0.05). The multivariate logistic regression analysis confirmed that age ≥40 yr. [partial regression coefficient ()=2.100)], BMI ≥24 kg/m (relative to 18.5-23.9 kg/m)(=1.842) , clinical stage ⅡA (relative to phase ⅠB, =2.401) , trans-abdominal operative method (relative to laparoscopy, =1.347), no NACT (=1.540) and post-NACT operative opportunity <2 or >3 weeks (relative to within 2-3 weeks) (=1.723) were independent predictors of higher intraoperative blood loss (≥500 mL).

CONCLUSION

Clinical stage and age, etc. are risk factors associated with intraoperative blood loss in patients with early cervical cancer.

摘要

目的

确定早期宫颈癌(ⅠB - ⅡA期)患者术中失血的相关危险因素。

方法

回顾性分析2010年12月至2017年9月在四川大学华西第二医院接受早期宫颈癌手术治疗的892例患者的病历:其中术中失血≥500 mL的患者127例,术中失血少于500 mL的患者765例。通过单因素和多因素统计方法分析两组患者在年龄、体重指数(BMI)、妊娠次数、腹部和盆腔手术史、慢性盆腔炎、临床分期、手术方式、新辅助化疗(NACT)及NACT后手术时机、术前和术后血红蛋白水平以及术中输血量等方面的差异。

结果

单因素分析确定年龄、BMI、妊娠次数、腹部和盆腔手术史、慢性盆腔炎、临床分期、手术方式、NACT及NACT后手术时机是与术中失血相关的显著因素(P<0.05)。多因素logistic回归分析证实,年龄≥40岁[偏回归系数(β)=2.100]、BMI≥24 kg/m²(相对于18.5 - 23.9 kg/m²)(β=1.842)、临床分期ⅡA期(相对于ⅠB期,β=2.401)、经腹手术方式(相对于腹腔镜手术,β=1.347)、未进行NACT(β=1.540)以及NACT后手术时机<2周或>3周(相对于2 - 3周内)(β=1.723)是术中失血较多(≥500 mL)的独立预测因素。

结论

临床分期和年龄等是早期宫颈癌患者术中失血的危险因素。

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