發(fā)布時間：2018-05-20 16:38

  本文選題：C反應蛋白 + 輸血��； 參考：《中國輸血雜志》2016年06期

【摘要】：目的探討C反應蛋白水平與骨折手術術后輸血不良反應發(fā)生率的相關性。方法選擇本院2012年7月—2015年1月,接受骨折手術治療的103例患者為研究對象,按照術中輸血方式不同將所有患者分為自體輸血組51例和異體輸血組52例。采用免疫熒光法測定輸血前后的患者全血C反應蛋白水平,同時對2組患者的術中出血量、輸血量及術后并發(fā)癥情況進行比較,并對CRP水平與輸血并發(fā)癥進行相關分析。結果異體輸血組患者輸血后CRP水平為(18.9±7.2)mg/L,與輸血前(8.2±6.4)mg/L相比較顯著升高(t=4.251,P0.05);異體輸血組術后3d測定全血CRP水平為(12.7±4.2)mg/L,與輸血前比較,差異有統計學意義(t=-2.289,P0.05),但與輸血后24 h內CRP水平相較仍有所下降(t=2.268,P0.05);自體輸血組C反應蛋白水平在輸血前后無統計學差異(F=0.084,P0.05)。異體輸血與自體輸血相比,輸血后C反應蛋白水平具有明顯差異(t=-3.545,P0.05;t=-3.545,P0.05)。51例自體輸血組患者中共發(fā)生3例輸血并發(fā)癥(5.88%),52例異體輸血組患者中并發(fā)癥感染11例(21.15%),2組感染率比較,差異有統計學意義(χ2=5.113,P0.05),異體輸血組并發(fā)癥發(fā)生率較高,變化趨勢與CRP水平一致,經單因素相關分析顯示,異體輸血組的CRP水平與輸血并發(fā)癥的發(fā)生率呈正相關(rs=0.569,tr=2.673,P0.05)。結論異體輸血C反應蛋白水平與骨折手術術后并發(fā)癥發(fā)生率呈正相關,C反應蛋白可能對骨折術后輸血不良反應的發(fā)生發(fā)展具有一定的預測價值。
[Abstract]:Objective to investigate the correlation between C reactive protein level and the incidence of transfusion adverse reaction after fracture surgery. Methods from July 2012 to January 2015, 103 patients who received surgical treatment for fracture were divided into two groups: autotransfusion group (n = 51) and allogeneic transfusion group (n = 52). The whole blood C-reactive protein levels before and after blood transfusion were measured by immunofluorescence method. The intraoperative blood loss, blood transfusion volume and postoperative complications were compared between the two groups, and the correlation between the level of CRP and the complications of blood transfusion was analyzed. Results the CRP level in allogeneic blood transfusion group was 18.9 鹵7.2 mg / L, which was significantly higher than that in pre-transfusion group (8.2 鹵6.4)mg/L), and the whole blood CRP level in allogeneic blood transfusion group was 12.7 鹵4.2 mg / L on the 3rd day after operation, compared with that before blood transfusion. The difference was statistically significant (P 0.05), but the level of CRP was still lower than that within 24 h after blood transfusion, while the level of C-reactive protein in autologous transfusion group had no statistical difference before and after blood transfusion. Compared with autologous blood transfusion, the level of C-reactive protein in allogeneic blood transfusion was significantly different from that in autologous blood transfusion. There were significant differences in C-reactive protein level between two groups. Among 51 cases of autotransfusion group, there were 3 cases of blood transfusion complications and 52 cases of allogeneic blood transfusion group. The infection rate of 11 cases of complication infection was 21.1555%. The difference was statistically significant (蠂 2 / 5.113 / P 0.05). The incidence of complications in allogeneic blood transfusion group was higher, and the change trend was consistent with the level of CRP. The single factor correlation analysis showed that there was a positive correlation between the CRP level of allogeneic blood transfusion group and the incidence rate of transfusion complications. Conclusion the level of C-reactive protein in allogeneic blood transfusion is positively correlated with the incidence of postoperative complications of fracture surgery. It may have some predictive value for the occurrence and development of adverse reaction of transfusion after fracture.
【作者單位】： 哈爾濱醫(yī)科大學附屬第一醫(yī)院輸血科;
【分類號】：R457.13;R687.3

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