自体血回输用于前列腺癌根治术的安全性及预后分析

Safety and efficacy of autologous blood transfusion in the radical prostatectomy

摘要:

目的 探讨自体血回输对前列腺癌根治术安全性及预后的影响。方法 回顾性分析2012年6月—2015年6月于天津市第一中心医院接受前列腺癌根治术的103例患者临床资料，将术中接受异体血回输的51例患者作为异体组，接受自体血回输的52例患者作为自体组。比较两组患者手术相关指标、免疫功能、血常规［红细胞（RBC）、血红白蛋白（HGB）、红细胞比积（HCT）］、并发症发生情况及随访5年内复发率、无瘤生存率。结果 自体组手术时间、住院时间较异体组短（P <0.05），术中失血量、医疗费用较异体组少（P <0.05）。两组患者术前免疫功能指标比较，差异无统计学意义（P >0.05）。自体组术后CD4⁺、CD8⁺高于异体组（P <0.05），Th1/Th2值低于异体组（P <0.05）。两组患者术前血常规指标比较，差异无统计学意义（P >0.05）；自体组术后血常规指标高于异体组（P <0.05）。两组患者并发症总发生率比较，差异无统计学意义（P >0.05）。两组患者术后5年总复发率、术后5年总无瘤生存率比较，差异无统计学意义（P >0.05）。结论 前列腺癌根治术中应用自体血回输可有效缩短手术用时，减少术中失血量，改善患者血常规指标，避免免疫抑制，但对并发症、复发率、无瘤生存率无明显影响。

Abstract:

Objective To investigate the safety and efficacy of autologous blood transfusion in radical prostatectomy.Methods The clinical data of 103 patients with prostate cancer who underwent radical prostatectomy in Tianjin First Central Hospital from June 2012 to June 2015 were retrospectively analyzed. Fifty-one patients who received intraoperative allogeneic blood transfusion were included in the allogeneic group, while another 52 patients who received autologous blood transfusion were included in the autologous group. The surgery-related indicators, immune function, red blood corpuscle (RBC) count, hemoglobin (HGB) content, hematocrit (HCT), complications, and 5-year recurrence rate and disease-free survival rate were compared between the two groups.Results Compared with the allogenic group, the operative duration and the length of hospital stay were shorter, intraoperative blood loss was less, and medical expenses were lower in the autologous group (P < 0.05). There was no difference in the immune indicators before the surgery (P >0.05). However, the frequency of CD4⁺ and CD8⁺ cells was higher, but the Th1/Th2 ratio was lower in the autologous group relative to the allogenic group after the surgery (P < 0.05). The preoperative RBC count, HGB content and HCT were not different between the two groups (P > 0.05), yet these indicators were higher in the allogenic group after the surgery (P < 0.05). In addition, no significant difference was found between the two groups in the overall incidence of complications and the 5-year overall recurrence rate and disease-free survival rate postoperatively (P > 0.05).Conclusions The application of autologous blood transfusion in radical prostatectomy can effectively shorten the operative duration, reduce intraoperative blood loss and improve certain routine blood biochemical indexes, but has no obvious influence on the incidence of complications, recurrence rate or disease-free survival rate.