| 王 佩,郭晓云,邓 齐,等.宫颈癌根治性子宫切除术患者术中输血的危险因素分析[J].肿瘤学杂志,2025,31(3):208-213. |
| 宫颈癌根治性子宫切除术患者术中输血的危险因素分析 |
| Influencing Factors of Intraoperative Blood Transfusion in Patients with Radical Hysterectomy for Cervical Cancer |
| 投稿时间：2024-09-27 |
| DOI：10.11735/j.issn.1671-170X.2025.03.B005 |
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| 中文关键词: 宫颈肿瘤 红细胞分布宽度 白蛋白 术中输血 子宫切除术 |
| 英文关键词:cervical neoplasms red blood cell distribution width albumin intraoperative blood transfusion hysterectomy |
| 基金项目:陕西省重点研发计划项目（2019SF-137） |
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| 摘要点击次数: 55 |
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| 中文摘要: |
| 摘 要：［目的］ 探讨影响宫颈癌根治性子宫切除术患者术中输血的临床因素。［方法］ 回顾性分析2019年12月至2023年5月在西北妇女儿童医院接受开放或腹腔镜根治性子宫切除术的371例宫颈癌患者临床资料，将患者分为术中输血组及术中未输血组，并纳入人口统计学、肿瘤病理特征、手术信息和术前实验室数据等进行术中输血危险因素分析。采用?字2检验或Fisher精确概率法分析分类数据，使用独立样本t检验或Mann-Whitney U检验评估连续数据。通过Logistic模型和受试者工作特征曲线（receiver operating characteristic，ROC）分析术前红细胞分布宽度/白蛋白（red blood cell distribution width/albumin，RDW/ALB）与术中输血的关系。［结果］ 在371例宫颈癌患者中，术中输血组患者55例（14.82%，55/371）。术中输血组RDW/ALB显著高于术中未输血组［0.67（0.59，0.91） vs 0.50（0.43，0.60），Z=-7.356，P＜0.001］。经多因素Logistic回归分析，开放性手术（HR=2.950，P=0.005）、美国麻醉医师协会分级≥3（HR=3.530，P＜0.001）和RDW/ALB（HR=28.932，P＜0.001）均是影响术中输血的独立危险因素。在调整了多种临床指标后，术前RDW/ALB仍与宫颈癌患者术中输血独立相关（P＜0.05）。RDW/ALB预测术中输血的ROC曲线下面积为0.811（95%CI：0.754～0.867）。截断值为0.565时，灵敏度和特异度分别为0.818、0.684。［结论］ 术前高RDW/ALB可能是根治性子宫切除宫颈癌患者术中输血的重要危险因素。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the influencing factors of intraoperative transfusion risk during radical hysterectomy in cervical cancer patients. ［Methods］ A total of 371 patients with cervical cancer who underwent open or laparoscopic radical hysterectomy between December 2019 and May 2023 were enrolled in this study， among whom 55 cases(14.82%) received blood transfusions during the surgery. The demographic data， tumor pathological features， surgical information， and preoperative laboratory findings of patients were collected. The factors related to intraoperative blood transfusion were analyzed with Logistic regression and the predictive value of the factors for intraoperative blood transfusion was evaluated with receiver operating characteristic (ROC) curve. ［Results］ The red blood cell width/albumin (RDW/ALB) in patients with intraoperative blood transfusion was significantly higher than those without transfusion ［0.67 (0.59， 0.91) vs 0.50 (0.43， 0.60)， Z=-7.356， P＜0.001］. Multivariate Logistic regression showed that open surgery (HR=2.950， P=0.005)， American Society of Anesthesiologists Classification ≥3 (HR=3.530， P＜0.001)， and RDW/ALB (HR=28.932， P＜0.001) were independent influencing factors of intraoperative blood transfusion. ROC analysis showed that the area under the curve(AUC) of RDW/ALB for predicting intraoperative blood transfusion was 0.811(95%CI： 0.754～0.867， P＜0.001) with a sensitivity and specificity of 0.818 and 0.684 (cutoff value=0.565)， respectively. ［Conclusion］ Preoperative high RDW/ALB may be used for predicting intraoperative blood transfusion in cervical cancer patients undergoing radical hysterectomy. |
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