[Objective] To evaluate the long-term effectiveness of an intelligent blood transfusion system in intraoperative blood management by comparing its performance with clinicians' decisions. [Methods] A retrospective analysis of 26 760 surgical cases (2017-2024) was conducted, comparing pre- and post-implementation (2017-2019 vs 2020-2024) metrics, including transfusion prediction accuracy, rationality of blood use, and clinical outcomes. The system, powered by XGBoost, integrated patient demographics, laboratory results, and surgical data to predict red blood cell transfusion needs. [Results] The intelligent blood transfusion systems achieved an accuracy of 80.62% in predicting transfusion necessity, significantly outperforming clinicians (24.83%, P<0.001). Its blood-use rationality rate was 83.92% vs 18.02% for clinicians (P<0.001). Post-implementation, major surgeries (grades Ⅲ-Ⅳ) increased while the requested blood units decreased. High physician compliance (>75%) correlated with 88.18% rationality. [Conclusion] The intelligent blood transfusion system significantly improves the accuracy of transfusion decision-making, reduces excessive red blood cell use, optimizes perioperative transfusion management, and enhances the utilization of blood medical resources.

Objective: To evaluate the effect of a new type of sterile elastic exsanguination tourniquet (SEET) in aspiration surgery for upper limb lymphedema. Methods: The clinical data of 159 patients who underwent aspiration surgery for upper limb lymphedema from January 2017 to June 2022 in the Beijing Shijitan Hospital, Capital Medical University were retrospectively analyzed. Among them, 54 patients were treated with SEET (SEET group), while 105 patients were not treated with SEET (No-SEET group). The propensity score matching method was used, and the surgical indicators and complications were compared between the two groups. The factors affecting intraoperative bleeding volume were analyzed through multiple linear regression analysis. Results: A total of 49 pairs of patients were successfully matched by the propensity score method. The age of patients in the SEET and No-SEET groups was (57.7±8.9) years and (56.8±9.1) years, respectively. Compared with the Non-SEET group, the SEET group had less bleeding volume [(311±164) ml vs (437±173) ml, P<0.001]. The results of multiple linear regression analysis showed that the factors affecting intraoperative bleeding volume included age (β=-0.142, P=0.041), using the SEET (β=-0.249, P=0.002), surgical time (β=0.195, P=0.010) and the amount of fat mixture sucked out (β=0.464, P<0.001). Conclusions: The clinical application of the SEET in aspiration surgery for upper limb lymphedema is safe, and can significantly reduce the bleeding volume and alleviate blood shortage.

Motivation Ovarian cancer (OC) is a highly lethal gynecological malignancy. Extensive research has shown that OC cells undergo significant metabolic alterations during tumorigenesis. In this study, we aim to leverage these metabolic changes as potential biomarkers for assessing ovarian cancer. Methods A functional module-based approach was utilized to identify key gene expression pathways that distinguish different stages of ovarian cancer (OC) within a tissue biopsy cohort. This cohort consisted of control samples ( n = 79), stage I/II samples ( n = 280), and stage III/IV samples ( n = 1016). To further explore these altered molecular pathways, minimal spanning tree (MST) analysis was applied, leading to the formulation of metabolic biomarker hypotheses for OC liquid biopsy. To validate, a multiple reaction monitoring (MRM) based quantitative LCMS/MS method was developed. This method allowed for the precise quantification of targeted metabolite biomarkers using an OC blood cohort comprising control samples ( n = 464), benign samples ( n = 3), and OC samples ( n = 13). Results Eleven functional modules were identified as significant differentiators (false discovery rate, FDR < 0.05) between normal and early-stage, or early-stage and late-stage ovarian cancer (OC) tumor tissues. MST analysis revealed that the metabolic L-arginine/nitric oxide (L-ARG/NO) pathway was reprogrammed, and the modules related to "DNA replication" and "DNA repair and recombination" served as anchor modules connecting the other nine modules. Based on this analysis, symmetric dimethylarginine (SDMA) and arginine were proposed as potential liquid biopsy biomarkers for OC assessment. Our quantitative LCMS/MS analysis on our OC blood cohort provided direct evidence supporting the use of the SDMA-to-arginine ratio as a liquid biopsy panel to distinguish between normal and OC samples, with an area under the ROC curve (AUC) of 98.3%. Conclusion Our comprehensive analysis of tissue genomics and blood quantitative LC/MSMS metabolic data shed light on the metabolic reprogramming underlying OC pathophysiology. These findings offer new insights into the potential diagnostic utility of the SDMA-to-arginine ratio for OC assessment. Further validation studies using adequately powered OC cohorts are warranted to fully establish the clinical effectiveness of this diagnostic test.

目的 评价富血小板纤维蛋白(platelet-rich fibrin,PRF)对宫腔粘连创面修复的形态学影响.方法 将经宫腔镜证实为宫腔粘连的患者68例按1:1随机分为PRF组与对照组,均行宫腔镜宫腔粘连分离术(TCRA)并留取子宫内膜组织,PRF组在TCRA后即刻、4周后宫腔置入PRF,对照组宫腔内未置入药物.8周后两组均行宫腔镜二探术评估粘连情况并再次留取子宫内膜组织.评估治疗前与治疗后8周子宫内膜形态学变化.结果 形态学研究显示PRF组治疗后腺体数量、Ki67、细胞角蛋白18(Cytokeratin 18,CK-18)、波形蛋白(Vimentin)平均荧光强度均增加,纤维化面积比例减小.PRF组子宫内膜腺体数量、Ki67平均荧光强度均显著高于对照组(P<0.05);纤维化面积比例小于对照组(P<0.01).结论 应用PRF治疗宫腔粘连,可以显著促进创面修复.

目的:探讨患者直接抗球蛋白试验(direct antiglobulin test,DAT)阳性强度的关键影响因素,对临床DAT阳性患者在抗生素用药或红细胞输血时提供指导.方法:回顾性分析首都医科大学附属北京世纪坛医院2015年1月至2020年12月27 382例次行DAT检测的患者资料,对患者性别、年龄、临床诊断、抗生素使用、红细胞输注、DAT阳性强度等进行统计分析.结果:共有27 382人次患者进行了 DAT检测,DAT阳性患者5 745人次(20.98％).将不同DAT强度患者按男、女分组后做Mann-Whitney U检验,结果显示,男性DAT+强度高于女性,组间差异有统计学意义(U=2 764 704.5,P＜0.001).将DAT阳性患者按年龄分为3组(＜18岁组、18～60岁组和＞60岁组)后做Kruskal-Wallis检验.结果 显示,不同年龄组间DAT阳性强度差异有统计学意义(H=200.4,P＜0.001),＜18岁组和＞60岁组DAT阳性强度高于18～60岁组.不同临床诊断之间分析结果显示DAT阳性强度差异有统计学意义(H=70.82,P＜0.001).Mann-Whitney U检验结果显示,使用抗生素和未使用抗生素组患者的DAT阳性强度分布不同,使用抗生素组患者DAT阳性强度更高(U=1 853 921.5,P＜0.001).红细胞输注组患者DAT阳性强度更高(U=3 315 953.5,P＜0.001),但多次红细胞输注并未引起DAT阳性强度变化(U=108 911.5,P=0.68).结论:在DAT阳性患者中,患者的性别、年龄、临床诊断、抗生素的应用、红细胞输注等均影响其DAT阳性强度,多次红细胞输注未见引起DAT+强度变化,临床上对DAT阳性强度较高的患者应谨慎使用抗生素及进行红细胞输注.

目的:综合评价贮存式自体输血(preoperative autologous blood donation,PABD)在肺癌手术患者中的临床应用效果.方法:回顾性分析2018年08月至2020年05月在我院行肺癌根治手术的患者共415例.其中80例采用贮存式自体输血(PABD组),335例未采用(No-PABD组).采用倾向性评分匹配功能进行匹配,比较匹配后的两组患者的术中出血量、术中异体血输注量、输血不良反应、术后胸腔引流量、围术期的血红蛋白(Hb)、血小板(PLT)变化情况等指标.结果:采用1:1最邻近匹配法,经倾向性评分匹配后成功匹配80对患者.PABD组采血后Hb、红细胞(RBC)、红细胞压积(Hct)水平均低于采血前,差异有统计学意义(P<0.05);而PLT水平在采血前后无统计学差异(P>0.05).两组患者在术后1、3、7天的Hb和PLT变化基本一致,差异无统计学意义(P>0.05).PABD组术中出血量[(474.9±325.9)mL vs(458.1±281.5)mL]、术后胸水引流量[(873.0±360.3)mL vs(774.5±341.7)mL]及住院时间[(9.4±3.3)d vs(9.8±2.6)d]与No-PABD组比较无明显差异(P>0.05).而PABD组异体血输注量(4000 mL vs 8800 mL)、异体血输入率(8.8％vs 23.8％)及输血相关费用[(189.5±92.2)元vs(337.8±426.8)元]均低于No-PABD组.结论:贮存式自体输血在肺癌手术患者中的临床应用是安全的,可以降低异体血输入率,减少输血相关费用.

Background and Objective:Liposuction is an effective treatment for fat disposition in lymphedema. Blood transfusion has been seldom investigated in lymphedema liposuction surgery. The purpose of the study was to analyze clinical factors associated with blood transfusion in liposuction surgery of lymphedema patients and compare the autologous and allogeneic transfusion patterns.Methods:A total of 1,187 cases of liposuction due to lymphedema were recruited. Demographic, laboratory tests and operation information were collected. Patients were divided into a transfusion and a non-transfusion group. Different transfusion patterns were compared and analyzed.Results:Between the two groups, there is a significant difference in postoperative hemoglobin levels, and as well as gender, age, surgery duration, body weight change, intraoperative transfusion volume and blood loss, hospital length of stay, and surgical site distribution. There is a significant difference in the comparison of hospital stay length, autologous transfusion volume, combined allogeneic volume, operative blood loss, intraoperative transfusion volume, and change in hemoglobin levels between predonation and acute normovolemic hemodilution (ANH) transfusion. In comparison with the allogeneic transfusion-only patients, the mean allogeneic transfusion volume in either ANH group, predonated transfusion group, or mixed group is statistically lower. Allogeneic transfusion volume in the predonated-only group is significantly lower than that of either the ANH-only group or the mixing ANH with predonation group. Ordinary least squares regression analysis suggests that autologous transfusion in the ANH-only mode is statistically associated with allogeneic transfusion.Conclusions:This study described the blood transfusion in lymphedema liposuction surgery and compared autologous and allogeneic transfusion patterns in these patients. Autologous transfusion can reduce the transfusion volume of allogeneic blood and might be a beneficial mode of transfusion in these patients.

目的 探讨输血闭环管理信息系统的应用效果.方法 收集红细胞和血浆用量较大的ICU病区、肾内科、消化内科、介入治疗科血液输注相关数据,以2018年5月-7月为系统应用前,以2019年4月-7月为应用后,进行比较分析.结果 取血时间及输注等待时间缩短,悬浮红细胞、血浆输注时限符合要求率提高.结论 将闭环管理应用于临床血液制剂输注全过程,实现了对临床血液制剂输注全过程的实时监控,避免了人为因素对血液制剂输注安全性造成的不良后果,提升了输血管理质量,保障了临床输血安全.

Objective:To explore a convenient and effective method for calculating intraoperative blood loss in liposuction and volume reduction surgery for establishing intraoperative autologous blood transfusion threshold.Methods:Patients’ clinical, laboratory and surgery related information were collected. The influence of different factors such as the total amount of liposuction, bloody fluid, operation time, and patients’ weight change on blood loss during operation were analyzed. The difference of volume between blood loss recorded by doctors and theoretical calculations was compared. The formula of blood loss during operation was conducted, and then the threshold of autologous blood transfusion was established.Results:A total of 1 136 patients with liposuction due to lymphedema were recruited. There were 65 males and 1 071 females, the median age was 56 years in the non-transfusion group and 55 years in the transfusion group. The total amount of liposuction, bloody fluid, operation time, and body weight changes in patients with liposuction surgery were statistically positively correlated with intraoperative blood loss (spearman coefficient were 0.590, 0.584, 0.560, 0.520, respectively, P<0.01). The theoretical blood loss calculated by the Hemoglobin balance formula is (753.0±418.2) ml. According to the calculated value of blood loss, the intraoperative blood loss fitting formula y(ml)=0.082×total liposuction+ 365, is abtained. The threshold for reinfusion of autologous blood is 2 900 ml of liposuction amount. Conclusions:In this study, a convenient calculation method of blood loss in liposuction and volume reduction surgery was constructed, and a threshold for autologous blood transfusion in surgery was set up. Thus, the indication of early blood transfusion was established.

Background: Predicting the perioperative requirement for red blood cells (RBCs) transfusion in patients with the pelvic fracture may be challenging. In this study, we constructed a perioperative RBCs transfusion predictive model (ternary classifications) based on a machine learning algorithm. Materials and Methods: This study included perioperative adult patients with pelvic trauma hospitalized across six Chinese centers between September 2012 and June 2019. An extreme gradient boosting (XGBoost) algorithm was used to predict the need for perioperative RBCs transfusion, with data being split into training test (80%), which was subjected to 5-fold cross-validation, and test set (20%). The ability of the predictive transfusion model was compared with blood preparation based on surgeons' experience and other predictive models, including random forest, gradient boosting decision tree, K-nearest neighbor, logistic regression, and Gaussian naïve Bayes classifier models. Data of 33 patients from one of the hospitals were prospectively collected for model validation. Results: Among 510 patients, 192 (37.65%) have not received any perioperative RBCs transfusion, 127 (24.90%) received less-transfusion (RBCs < 4U), and 191 (37.45%) received more-transfusion (RBCs ≥ 4U). Machine learning-based transfusion predictive model produced the best performance with the accuracy of 83.34%, and Kappa coefficient of 0.7967 compared with other methods (blood preparation based on surgeons' experience with the accuracy of 65.94%, and Kappa coefficient of 0.5704; the random forest method with an accuracy of 82.35%, and Kappa coefficient of 0.7858; the gradient boosting decision tree with an accuracy of 79.41%, and Kappa coefficient of 0.7742; the K-nearest neighbor with an accuracy of 53.92%, and Kappa coefficient of 0.3341). In the prospective dataset, it also had a food performance with accuracy 81.82%. Conclusion: This multicenter retrospective cohort study described the construction of an accurate model that could predict perioperative RBCs transfusion in patients with pelvic fractures.

目的 比对引入的国产仪器与现有进口仪器的交叉配血试验检测准确性、重复性,探讨引入新仪器后的应用流程和双向传输对提高结果报告准确性的作用.方法 用新鲜抗凝全血在WADiana和国产AISEN120两台仪器上进行交叉重复性试验,通过比对两台仪器的结果报告、凝集强度,评价AISEN120检测结果的准确性和与WADiana的一致性.并通过医院LIS和HIS系统,采用了数据接口软件技术,进行医嘱和实验室结果的双向传输.结果 两台仪器分别进行300例血型鉴定和100例交叉配血实验,调整照相判读系统、加样系统以及对耗材进行检测前的质量控制后,两台仪器血型鉴定和交叉配血试验的结果符合率分别为98％和100％,血型鉴定与试管法结果符合率为99％.结论 AISEN120检测结果与进口仪器准确性一致,所有结果均可传输到专有软件中保存,双向传输功能的引入可减少人为差错.本研究可为其他医疗机构选用相关国产仪器提供了有价值的基础数据和应用流程模式参考.

如何规范医师用血行为,促进临床合理用血,值得医院深入探讨.首都医科大学附属北京世纪坛医院以临床决策支持系统和人工智能为抓手,融合大数据技术,构建了临床输血智能管理系统.系统应用后,医院围术期红细胞输注预测准确率持续提高;管理和科研模块可以直接输出与输血有关信息,为管理部门提供了各类数据报告,并为科研提供了数据支持.

Objective To evaluate the efficacy of autologous platelet-rich fibrin (PRF) in the treatment of infertility due to intrauterine adhesion. Methods From October 2018 to October 2019, 40 patients diagnosed as intrauterine adhesion and excluded other infertility factors in Beijing Shijitan Hospital were randomly divided into PRF group and control group, with 20 cases in each group. The intervention lasted for 8 weeks. Patients in both groups underwent transcervical resection of adhesion (TCRA), and PRF was placed in the uterine cavity immediately after TCRA and 4 weeks later in the PRF group. After 8 weeks of TCRA, a second hysteroscopy was performed, and then follow-up was performed. Pregnancy rate, intrauterine adhesions score, menstruation, and endometrial thickness (EMT) were compared between two groups. Results The pregnancy rate of the PRF group was 70.00%, which was significantly higher than 20.00% of the control group (P 0.05). Conclusion The placement of PRF combined with the TCRA can improve the pregnancy rate of infertility due to intrauterine adhesion, reduce intrauterine adhesion scores, and improve clinical symptom.

Objective: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a standard treatment for pseudomyxoma peritonei (PMP) recommended by Peritoneal Surface Oncology Group International (PSOGI). The study is to analyze the incidence of perioperative serious adverse events (SAEs) of CRS + HIPEC to treat PMP patients, and identify the risk factors, for guiding the prevention of SAEs. Methods: This is a retrospective study on the PMP database established at our center. The clinicopathological features, treatment details and SAEs information on the PMP patients are systematically established in this database. The incidence, organ system distribution and severity of perioperative SAEs are analyzed. Univariate and multivariate analyses are performed to identify the independent risk factors. Results: Among the 272 CRS + HIPEC procedures for 254 PMP patients, there are 93 (34.2%) SAEs. Six systems are involved in the SAEs, including infections (9.6%), digestive system (8.1%), respiratory system (6.3%), cardiovascular system (5.5%), hematological system (2.9%), and urinary system (1.5%), in terms of frequency. In terms of severity, the majority is grade III SAEs (27.9%), followed by grade IV SAEs (4.8%) and grade V SAEs (1.5%). Univariate analysis reveals 4 risk factors for perioperative SAEs: HIPEC regimens (P = 0.020), PCI (P = 0.025), intraoperative red blood cell transfusion volume (P = 0.004), and intraoperative blood loss volume (P = 0.002). Multivariate and logistic regression model analysis identifies only one independent risk factor for perioperative SAEs: intraoperative blood loss volume (P = 0.001, OR = 0.344, 95%CI: 0.182-0.649). Conclusions: PMP patients treated by CRS + HIPEC at experienced centers could have acceptable safety. Improving the surgical techniques and developing the integrated hemostasis techniques are essential to reduce intraoperative blood loss and decrease SAEs rate. (C) 2020 The Authors. Published by Elsevier Ltd.

Objective: This study was to investigate the perioperative safety of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP), and analyze the risk factors of serious adverse events (SAEs). Methods: The occurrences of perioperative SAEs were retrospectively analyzed in 254 PMP patients treated with CRS plus HIPEC. Univariate and multivariate analysis were performed to identify independent risk factors. Results: Among the 272 CRS plus HIPEC procedures for 254 PMP patients, a total of 93 (34.2%) perioperative SAEs occurred, including 26 in infection, 22 in digestive system, 17 in respiratory system, 15 in cardiovascular system, 8 in hematological system, and 4 in urinary system. In terms of severity, the vast majority was grade Ⅲ with 76 cases, followed by grade Ⅳ with 13 cases and grade Ⅴ with 4 cases. Univariate analysis revealed 3 risk factors of perioperative SAEs: HIPEC regimen (P=0.020), intraoperative red blood cell transfusion volume (P=0.004), and intraoperative blood loss volume (P=0.002). Multivariate analysis by logistic regression model analysis revealed that intraoperative red blood cell transfusion volume was an independent risk factor for perioperative SAEs (OR=1.160, P=0.001). Conclusion: In conclusion, the perioperative safety of CRS plus HIPEC was acceptable. Moreover, intraoperative blood loss volume and red blood cell transfusion volume are expected to be reduced in order to prevent SAEs for PMP patients.

IntroductionCytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a well-established treatment for peritoneal cancer (PC). However, this kind of combination therapy is associated with a high incidence of complications. Moreover, relative studies have indicated that traditional laboratory testing is insufficient to demonstrate the overall haemostatic physiology of CRS/HIPEC. Thromboelastography (TEG), administered by monitoring dynamic changes in haemostasis, has been shown to contribute to reducing transfusion requirements and improving survival. However, there is no evidence to verify whether TEG can be applied to guide transfusion strategies during CRS/HIPEC. Therefore, we aim to investigate whether TEG-guided blood product transfusion (TEG-BT) therapy is superior to traditional blood product transfusion (T-BT) therapy for guiding perioperative blood transfusion treatment and improving the prognosis of patients undergoing CRS/HIPEC.Methods and analysisThe TEG-BT versus T-BT study is a single-centre, randomised, blinded outcome assessment clinical trial of 162 patients with PC, aged 18–64 years and undergoing CRS/HIPEC. Participants will be randomly allocated to receive TEG-BT or T-BT. The primary outcome will be the evaluation of perioperative blood transfusion, which refers to the total amount of blood transfusion given from the time patients enter the operating room up to 72 hours postoperatively. The secondary outcomes will include the transfusion volume during surgery, total amount of intraoperative infusion, amount of blood lost during the operation, total blood transfusion between 0 and 72 hours after surgery, lowest haemoglobin level within 72 hours after surgery, intensive care unit duration, overall length of stay, total cost of hospitalisation and adverse events. Data will be analysed according to the intention-to-treat principle.Ethics and disseminationThe study protocol has been approved by the Scientific Research Ethics Committee of Beijing Shijitan Hospital Affiliated with Capital Medical University (Approval Number: sjtkyll-lx-2020-3). The results will be published in peer-reviewed journals.Trial registration numberChinese Clinical Trial Registry (ChiCTR2000028835).

OBJECTIVE To investigate the related factors influencing plasma transfusion efficacy so as to improve the plasma transfusion efficiency. METHODS According to the clinical symptoms and the laboratorial results, the patients were divided into transfusion efficient and inefficient groups. A total of13090.8 units of plasma were transfused to 4423 patients. The clinical symptoms and the hemorrhage related index per- and pro-transfusion, plasma components sorts, storage time, and the dose of plasma (kg/ml) transfusion were analyzed. RESULTS The largest transfusion volume of plasma were in intensive care unit (ICU) accounted for 30.36%, the largest blood plasma per patient transfusion was in cardiac surgery (3.96 U). The analysis of transfusion efficiency showed that in terms of patient age, there were difference in transfusion efficiency among the patients with different ages (P＜0.001). The effective transfusion rate in the group of age ＜18 was 53%, which was higher than that in group of age 18-60(41%) and group of age ＞60 (30%); in terms of sex, the effective transfusion rate in female group was higher than that in male group (42% vs 37%) (P＜0.001); in terms of transfusion plasma volume/body weight, there were differences in transfusion efficiency (P＞0.05). The multi-factor logistic regression analysis showed that there was no significant correlation among the plasma sorts, storage time of the plasma pre-transfusion and transfusion efficiency(P＞0.05). The analysis of the non-hemolytic fever reaction caused by plasma transfusion revealed that there was no statistical difference between the plasma and the leukocyte-depleted plasma groups (P＞0.05). CONCLUSION The plasma transfusion effectiveness relates with age and sex, but not relates with the transfusion plasma voume/body weight, plasma sorts, and the duration of storage.

OBJECTIVE:To investigate the related factors influencing plasma transfusion efficacy so as to improve the plasma transfusion efficiency. METHODS:According to the clinical symptoms and the laboratorial results, the patients were divided into transfusion efficient and inefficient groups. A total of13090.8 units of plasma were transfused to 4423 patients. The clinical symptoms and the hemorrhage related index per- and pro-transfusion, plasma components sorts, storage time, and the dose of plasma (kg/ml) transfusion were analyzed. RESULTS:The largest transfusion volume of plasma were in intensive care unit (ICU) accounted for 30.36%, the largest blood plasma per patient transfusion was in cardiac surgery (3.96 U). The analysis of transfusion efficiency showed that in terms of patient age, there were difference in transfusion efficiency among the patients with different ages (P＜0.001). The effective transfusion rate in the group of age ＜18 was 53%, which was higher than that in group of age 18-60(41%) and group of age ＞60 (30%); in terms of sex, the effective transfusion rate in female group was higher than that in male group (42% vs 37%) (P＜0.001); in terms of transfusion plasma volume/body weight, there were differences in transfusion efficiency (P＞0.05). The multi-factor logistic regression analysis showed that there was no significant correlation among the plasma sorts, storage time of the plasma pre-transfusion and transfusion efficiency(P＞0.05). The analysis of the non-hemolytic fever reaction caused by plasma transfusion revealed that there was no statistical difference between the plasma and the leukocyte-depleted plasma groups (P＞0.05). CONCLUSION:The plasma transfusion effectiveness relates with age and sex, but not relates with the transfusion plasma voume/body weight, plasma sorts, and the duration of storage.

Objective: To investigate the effect of direct antiglobulin test (DAT) positive strength on the clinical effect of red blood cell transfusion. Methods: The clinical data was collected on blood transfusion compatibility test and clinical transfusion of patients who underwent DAT testing from January 2015 to March 2019 in the Department of Blood Transfusion, Beijing Shijitan Hospital affiliated to Capital Medical University. A retrospective cohort study method was used to analyze the correlation between the DAT positive strength and the blood match results, irregular antibody test results, bilirubin value after blood transfusion, and red blood cell transfusion effect. Results: According to the blood matching test results, the minor cross-matching results were significantly correlated with the DAT strength (r=0.58, P<0.01). The DAT strength of the antibody-screening positive patients was greater (χ(2)=126.810, P<0.01). DAT-positive strength influences the direct bilirubin, the higher the DAT-positive strength, the higher the direct bilirubin concentration of the patients (χ(2)=32.069, P<0.01). DAT-positive strength also had an effect on patients' total bilirubin value (χ(2)=17.981, P=0.001). From the effect of red blood cell transfusion, patients with a DAT positive strength of 0.5 had a lower effective rate of transfusion (28.6%). The remaining DAT strength had no relation to the effect of red blood cell transfusion, and the efficiency of blood transfusion in patients with different DAT-positive strengths (1, 2, 3, 4) was 57.0%, 60.1%, 65.6% and 60.0%, respectively. With the same DAT strength, the patient's transfusion efficiency was higher (χ(2)=41.071, P=0.009). Conclusion: Different DAT-positive strengths are correlated with the patient's minor cross-match results and bilirubin content, while the effect of red blood cell transfusion has no significant correlation with DAT-positive strength. However, with the increase of DAT positive strength, patients are more likely to have irregular antibodies.

目的:探讨影响血浆输注效果的相关因素,以期进一步提高患者血浆输注有效率和临床输注的合理性.方法:根据输血后患者临床症状改善情况和实验室凝血检测值将患者分为血浆输注有效和无效2组.对4 423例患者的基本临床资料和13 090.8 U的血浆输注过程中涉及的主要因素如输血浆前PT、APTT、血浆种类、保存时间、输注血浆体重比(kg/ml)等进行分类统计分析.结果:外科监护室患者血浆用量最多,占总血浆输注比例最大(30.36％),人均用血浆量最大的科室为心外科(3.96 U).从输注效果上看,不同年龄组患者的输血效果有差别(P＜ 0.001),＜18岁组患者血浆输注有效率(53％)高于18-60岁和＜60岁组,18-60岁组和＞60岁组患者血浆输注有效率分别为41％和30％;女性患者输血浆有效率(42％)高于男性(37％)(P＜0.001);按不同血浆体重比进行血浆输注效果比较显示无显著差异(P＞0.05);通过多因素Logistic回归分析,普通冰冻血浆、去白细胞血浆和新鲜冰冻血浆3类血浆的临床输注效果间没有差异;输注前血浆保存时间与输注效果之间无显著相关性.去白细胞血浆与未经去白的血浆相比,并未降低非溶血性发热性输血反应的发生率.结论:血浆输注效果的主要影响因素有患者年龄、性别,但与血浆体重比、血浆种类和血浆保存时间关系不大;只要于保存期内输注,保存时间的长短与输注效果间没有显著相关性.