[Diagnosis and treatment status of perioperative anemia in patients with gastrointestinal neoplasms: a multi-center study in Hubei Province].

Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ2 test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.目的： 了解湖北省胃肠道肿瘤患者围手术期贫血发生率及治疗现状。 方法： 采用网络数据库形式收集2019年湖北省15个市（州）62家医院7 474例接受手术治疗的胃肠道肿瘤患者的临床病理学资料。男性4 749例，女性2 725例，中位年龄62岁（范围：17~96岁）。根据患者入院第1次和术后第1天的血红蛋白值判断患者是否存在术前和术后贫血，90~<120 g/L（男性）或90~<110 g/L（女性）为轻度贫血，60~<90 g/L为中度贫血，<60 g/L为重度贫血。采用t检验或χ²检验进行组间比较。 结果： 全部患者术前贫血发生率为38.60%（2 885/7 474），术后贫血发生率为61.40%（4 589/7 474）。术前贫血患者中接受治疗的比例为26.86%（775/2 885），术后贫血患者中接受治疗的比例为14.93%（685/4 589）。三级甲等、三级乙等、二级甲等医院术前贫血患者中接受治疗的比例分别为26.12%（649/2 485）、32.32%（85/263）、29.93%（41/137），术后贫血患者中接受治疗的比例分别为14.61%（592/4 052）、22.05%（73/331）、9.71%（20/206）。术前贫血组患者术中输血比例［16.74%（483/2 885）比3.05%（140/4 589），χ²=434.555，P<0.01］和术后并发症发生率［17.78%（513/2 885）比14.08%（646/4 589），χ²=18.553，P<0.01］高于非贫血组，术前贫血组患者术后住院时间长于非贫血组［（14.1±7.3）d比（13.3±6.2）d，t=5.202，P<0.01］。 结论： 胃肠道肿瘤患者围手术期贫血发生率较高，术前贫血可增加患者术中输血需求并影响短期预后。目前湖北省胃肠外科医师的围手术期贫血规范化治疗理念有待提高。.