术中补血自体输注对颈动脉体瘤切除术后患者预后的影响。

Q3 Medicine
北京大学学报(医学版) Pub Date : 2025-04-18
Weihao Li, Jing Li, Xuemin Zhang, Wei Li, Qingle Li, Xiaoming Zhang
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引用次数: 0

摘要

目的:探讨术中补血自体输注对颈动脉体瘤切除术后局部复发和远期转移的影响。方法:我们回顾性分析了2009年8月至2020年12月连续61例接受选择性颈动脉体肿瘤切除术的患者。其中术中补救性自体输血14例(自体输血组),未输血47例(非自体输血组)。收集一般资料、手术情况及术后随访结果。结果:ShamblinⅢ在自体输血组中的比例为85.7%,显著高于非自体输血组的31.9% (P=0.003)。自体输血组14例患者平均手术时间为(264±84)min,术中出血量为1 200 (700,2 700)mL,自体输血量为500 (250,700)mL,其中8例(57%)患者需伴用异体血400 (260,400)mL。非自体输血组47例患者平均手术时间为(153±75)min,术中出血量300 (100,400)mL,其中6例(13%)患者需要输血异体血,使用异体血520 (400,520)mL。自体输血组平均手术时间明显长于非自体输血组(P < 0.001),术中输血量明显大于非自体输血组(P=0.007)。在接受自体输血的14例患者中,8例(57%)同时需要同种异体血液;而在47例非自体输血患者中,6例(13%)需要异体输血。自体输血组同时使用同种异体血的比例更高(P=0.002)。术后30天内神经损伤发生率为29.5%,两组比较差异无统计学意义。没有发生过早死亡。平均随访时间为(76±37)个月。非自体输血组局部复发1例。无远处转移。没有肿瘤相关的死亡。估计5年和10年总生存率分别为96.4%和83.8%。两组患者总生存率无统计学差异(P=0.506)。结论:术中补血自体输注无增加颈动脉体瘤患者局部复发和远处转移的风险,是颈动脉体瘤切除术安全有效的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Effect of intraoperative blood salvage autotransfusion on the prognosis of patients after carotid body tumor resection].

Objective: To investigate the effect of intraoperative blood salvage autotransfusion on local recurrence and long-term metastasis of patients after carotid body tumor resection.

Methods: We retrospectively reviewed a consecutive series of 61 patients undergoing elective carotid body tumor resection from August 2009 to December 2020. Among them, 14 received intraoperative blood salvage autotransfusion (autotrasfusion group) and 47 did not (non-autotransfusion). Data of general information, surgical status and postoperative follow-up results were collected.

Results: The proportion of Shamblin Ⅲ in the autotransfusion group was 85.7%, which was significantly higher than 31.9% in the non-autotransfusion group (P=0.003). The average operation time of the 14 patients in the autotransfusion group was (264±84) min, intraoperative blood loss was 1 200 (700, 2 700) mL, and autologous blood transfusion was 500 (250, 700) mL. Of these, 8 patients (57%) required concomitant allogeneic blood with 400 (260, 400) mL of allogeneic blood. The average operation time of the 47 patients in the non-autotransfusion group was (153±75) min, and the intraoperative blood loss was 300 (100, 400) mL. Of these, 6 (13%) required allogeneic blood transfusion, and 520 (400, 520) mL of allogeneic blood was used. Compared with the non-autotransfusion group, the average operation time in the autologous blood transfusion group was significantly longer (P < 0.001), and the intraoperative blood transfusion volume was larger (P=0.007). Of the 14 patients undergoing autotransfusion, 8 (57%) needed allogeneic blood at the same time; while in the 47 non-autologous transfusion patients, 6 (13%) needed allogeneic blood transfusion. The proportion of autotransfusion group using allogeneic blood at the same time was even higher (P=0.002). The incidence of nerve injury within 30 days after surgery was 29.5%, and there was no significant difference between the two groups. No early deaths occurred. The average follow-up was (76±37) months. One case of local recurrence occurred in the non-autotransfusion group. There was no distant metastasis. There were no tumor-related deaths. The estimated 5-year and 10-year overall survival rates were 96.4% and 83.8%, respectively. There was no significant difference in overall survival between the two groups (P=0.506).

Conclusion: The use of intraoperative blood salvage autotransfusion increased no risk of local recurrence and distant metastasis in patients with carotid body tumor, which is safe and effective in carotid body tumor resection.

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来源期刊
北京大学学报(医学版)
北京大学学报(医学版) Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
9815
期刊介绍: Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases. The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.
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