Mariette D, Smadja C, Naveau S, Borgonovo G, Vons C, Franco D
Department of General Surgery, Hôpital Antoine Béclère, Clamart, France.
Am J Surg. 1997 Apr;173(4):275-9. doi: 10.1016/S0002-9610(96)00400-X.
Hepatic resection remains a hemorrhagic procedure. The purpose of this study was to investigate the preoperative predictive factors of intraoperative blood transfusion.
One hundred consecutive patients who underwent hepatic resection for tumor were included in this retrospective study. Resection was performed for primary malignancies (n = 52), metastases (n = 18), and benign tumors (n = 30). Liver resection was performed under intermittent clamping of the portal triad. Seventeen variables were analyzed.
The operative blood loss was 1,872 mL (mean 1,104; range 650 to 4500) for the 22 transfused patients. The mean blood transfusion was 5.5 units (mean 3.2; range 2 to 12) of packed red cells. Multivariate analysis demonstrated that the size of liver resection (P <0.001) and the prothrombin rate (P <0.001) were independently correlated with blood transfusion.
Patients undergoing extended resection or with abnormal coagulation could be considered for autologous blood transfusion.
肝切除术仍然是一种出血性手术。本研究的目的是探讨术中输血的术前预测因素。
本回顾性研究纳入了100例因肿瘤接受肝切除术的连续患者。手术切除针对原发性恶性肿瘤（n = 52）、转移瘤（n = 18）和良性肿瘤（n = 30）。肝切除术在门静脉三联体间歇性阻断下进行。分析了17个变量。
22例输血患者的术中失血量为1872 mL（平均1104 mL；范围650至4500 mL）。平均输血量为5.5单位（平均3.2单位；范围2至12单位）浓缩红细胞。多因素分析表明，肝切除范围（P <0.001）和凝血酶原率（P <0.001）与输血独立相关。
接受扩大切除术或凝血异常的患者可考虑自体输血。
