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目的探讨输血浆对胃癌病人的预后影响。方法回顾性分析2005年1月至2009年12月首都医科大学附属北京友谊医院行胃癌根治术或姑息胃切除手术治疗的255例胃癌病人临床资料,对影响行胃切除的胃癌病人预后因素进行Cox回归分析,并对其围手术期输血浆分层分析,判断其对胃癌病人存活率的影响。结果多因素回归分析显示幽门梗阻、TNM病理分期、围手术期输血浆和肿瘤直径≥6 cm是影响胃癌病人预后的独立危险因素。分层分析提示Ⅱ和Ⅲ期胃癌、肿瘤直径<6 cm、术前无低白蛋白血症、无贫血病人输血浆者预后更差,差异具有统计学意义(P<0.05)。结论围手术期输血浆是影响胃癌病人预后的独立危险因素,其中对Ⅱ和Ⅲ期胃癌、肿瘤直径<6 cm、术前无低白蛋白血症及无贫血病人的影响更大。
Objective To investigate the effect of plasma transfusion on the prognosis of patients with gastric cancer. Methods The clinical data of 255 patients with gastric cancer who underwent radical gastrectomy or palliative gastrectomy at Beijing Friendship Hospital Affiliated to Capital Medical University from January 2005 to December 2009 were retrospectively analyzed. The prognostic factors of gastric cancer patients undergoing gastrectomy were retrospectively analyzed. Cox Regression analysis, and its perioperative blood plasma stratified analysis to determine the impact of gastric cancer survival rate. Results Multivariate regression analysis showed that pyloric obstruction, TNM pathological stage, perioperative plasma transfusion and tumor diameter ≥6 cm were independent risk factors for prognosis of gastric cancer patients. Stratified analysis showed that the prognosis of patients with stage II and III gastric cancer, tumor diameter <6 cm, no hypoalbuminemia before surgery and no anemia patients were worse, the difference was statistically significant (P <0.05). CONCLUSION: Perioperative plasma transfusion is an independent risk factor affecting the prognosis of patients with gastric cancer, of which stage Ⅱ and Ⅲ gastric cancer, tumor diameter <6 cm, preoperative hypoalbuminemia and anemia patients greater impact.