在下段剖腹产时常规使用细胞救援与术后铁输注和贫血之间存在关联
Tom P Fox1, Evelyn Timpani1, Amanda Green1
1Department of Anesthesia, Lyell McEwin Hospital, Elizabeth Vale, 5112, SA, Australia.
Archives of gynecology and obstetrics
|May 26, 2023
概括
在剖腹产期间进行常规的手术内细胞救援,显著减少了产后铁输注和贫血. 这种患者血液管理策略改善了术后血红蛋白水平,提高了母亲的结果.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 患者血液管理患者血液管理
背景情况:
- 术内细胞救援 (ICS) 是患者血液管理 (PBM) 的一个关键组成部分.
- 从历史上看,在下段剖腹产 (LSCS) 期间的ICS是基于出血风险评估.
- 随着COVID-19大流行,人们开始转向强制性ICS,以缓解产后贫血和减少血液制品的使用.
研究的目的:
- 为了评估常规的手术内细胞救援对母亲在下段剖腹产后的结果的影响.
- 为了确定强制性ICS是否会影响产后血红蛋白水平和贫血患病率.
- 评估常规ICS和产后铁输液的需要之间的关联.
主要方法:
- 采用了一个单一中心,前后研究设计.
- 两个组进行了比较:在LSCS期间选择性ICS (n=203) 和强制性ICS (n=228).
- 使用统计模型,包括反向概率权重,分析手术后的铁输注率和停留时间.
主要成果:
- 与常规护理组相比,强制性ICS组显示出更高的术后血红蛋白水平和更低的贫血率.
- 在强制性ICS组中,需要产后注射铁的患者显著减少 (OR=0.31).
- 两组之间在住院时间上没有显著差异.
结论:
- 在LSCS期间常规提供手术内细胞救援,与改善母亲的结果有关.
- 强制性ICS有效减少产后贫血和需要补充铁的需要.
- 这种做法增强了产科护理中的PBM策略.
相关概念视频
02:45Blood Transfusion and Agglutination
Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:28Esophageal Varices-II: Clinical Features and Management
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...