在状细胞疾病 (TAPS) 中进行手术前输血替代方案研究:一种随机,受控,多中心临床试验
Jo Howard1, Moira Malfroy, Charlotte Llewelyn
1Department of Haematology, Guy's and St Thomas' Hospital, London, UK. jo.howard@gstt.nhs.uk
Lancet (London, England)
|January 29, 2013
概括
在接受手术的状细胞病患者中,手术前输血显著减少了手术前并发症. 这种干预可能对接受中低风险手术的血红蛋白SS患者有益.
科学领域:
- 血液学 血液学 血液学
- 手术瘤学手术瘤学
- 输血医学 输血医学
背景情况:
- 在状细胞疾病 (SCD) 中,手术前输血的疗效仍在争论中.
- 评估手术前输血对SCD患者术后并发症率的影响.
研究的目的:
- 评估手术前输血是否会改变状细胞病患者的术后并发症率.
主要方法:
- 一个多中心的随机试验,涉及1岁或1岁以上的患有状细胞疾病 (血红蛋白SS或Sβ0) 的患者.
- 患者被随机分配,在手术前10天内接受不输血或输血.
- 主要结局是随机化至手术后30天临床重要并发症的比例,按治疗意图进行分析.
主要成果:
- 39%没有手术前输血的患者出现并发症,而输血患者为15% (p=0.023).
- 严重的不良事件发生在30% (不输血) 和3% (输血) 的患者中.
- 急性胸部综合征是主要的严重不良事件,无输血组有9例,输血组有1例.
结论:
- 术前输血与状细胞病患者的术后并发症减少有关.
- 这一策略对接受中低风险手术的血红蛋白SS患者具有潜在的益处.
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