Journal: Frontier Forum of Clinical Medicine DOI: 10.32629/ffcr.v3i10.21251
Abstract
目的：探讨肝移植术中大量输血的危险因素并建立术中大量输血的预测模型。方法：回顾性分析2015年1月-2023年8月在陆军军医大学第一附属医院肝胆外科行原位肝移植手术的250例患者相关资料，根据术中输血量将患者分为非大量输血组（188例）和大量输血组（62例），采用多因素logistic回归分析评估肝移植患者术中大量输血的危险因素及构建术中大量输血的预测模型，通过Hosmer-Lemeshow检验评价模型的校准度，受试者工作特征（receiver operating characteristic, ROC）曲线下面积（area under the curve, AUC）衡量模型的区分度。结果：logistic多因素分析结果显示术前血红蛋白〔比值比（odds ratio, OR）=0.958，95%置信区间 （confidence interval, CI）（0.943~0.974），＜0.01〕，白蛋白指标〔OR=0.938，95%CI（0.883~0.995），P=0.034〕，及手术时间长〔OR=1.212，95%CI（1.027~1.43），P=0.023〕是原位肝移植手术患者术中大量输血的危险因素。以此构建的logistic回归模型预测术中输血的受试者操作特征曲线下面积为 0.873 ［95%CI（0.808，0.919），P。结论：基于原位肝移植患者术前血红蛋白，白蛋白指标，手术时长建立预测模型可用于预测术中大量输血的风险。
Keywords
肝移植；输血；回顾性
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