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[与心脏直视手术后输血后肝炎发生率相关的临床因素]

[Clinical factors relating to the incidence of post-transfusion hepatitis following open heart surgery].

作者信息

Kugimiya T, Oka T, Kusaba E, Fukushima K, Kuroiwa M, Takagi M, Miyagawa H, Takagi Y, Tomita M, Shirabe J

出版信息

Nihon Geka Gakkai Zasshi. 1983 Mar;84(3):232-6.

PMID:6425637
Abstract

A retrospective study of post-transfusion hepatitis (PTH) has been made of 168 patients who had open-heart surgery between 1978 and 1981 at the Nagasaki University Hospital. The criteria of PTH was defined as an elevation of SGPT over 50 units with more than 2 weeks duration that occurred later than 3 weeks after the transfusion. PTH developed in 27 of the 168 patients (16%) and 26 of them were of the non-A, non-B type. The statistical analysis of these patients demonstrated that the following clinical factors significantly increased the incidence of PTH subsequent to open-heart surgery: (1) Use of plasma fractionating products made from pooled plasma, such as PPSB (p less than 0.001). (2) A large amount of blood and blood component transfusion (over 21 units, p less than 0.01). (3) Prolongation of the operation time (more than 330 minutes, p less than 0.05), cardiopulmonary bypass time (more than 90 minutes, p less than 0.05) and aortic cross-clamping time (more than 45 minutes, p less than 0.01), and (4) Surgery for cardiac lesions with left heart overloads (p less than 0.01).

摘要

对1978年至1981年期间在长崎大学医院接受心脏直视手术的168例患者进行了输血后肝炎(PTH)的回顾性研究。PTH的标准定义为输血后3周后出现的血清谷丙转氨酶(SGPT)升高超过50单位且持续超过2周。168例患者中有27例(16%)发生了PTH,其中26例为非甲非乙型。对这些患者的统计分析表明,以下临床因素显著增加了心脏直视手术后PTH的发生率:(1)使用由混合血浆制成的血浆分馏产品,如PPSB(p<0.001)。(2)大量输血和血液成分输血(超过21单位,p<0.01)。(3)手术时间延长(超过330分钟,p<0.05)、体外循环时间延长(超过90分钟,p<0.05)和主动脉阻断时间延长(超过45分钟,p<0.01),以及(4)治疗伴有左心负荷过重的心脏病变的手术(p<0.01)。

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