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[在接受手术内输血的非心脏手术患者的初始术后血红蛋白值和预后之间的相关性]
Wen-Zhu Chen1,2, Chun-Xia Chen1, Xin-Xin Yang1
1Department of Blood Transfusion, West China Hospital, Sichuan University, Chengdu 610041, China.
概括
在接受输血的非心脏手术患者中,初始术后血红蛋白 (Hb) 水平较低 (<85 g/L) 与更糟糕的结果相关. 较高的Hb水平没有显示额外的益处,这表明输血的目标范围.
科学领域:
- 麻醉学和重症监护医学
- 输血医学 输血医学
- 手术结果研究研究.
背景情况:
- 术内输血在非心脏手术中很常见.
- 输血后优化血红蛋白 (Hb) 水平对于患者的预后至关重要.
- 基于证据的输血指南旨在合理使用血液.
研究的目的:
- 研究初始术后血红蛋白 (Hb) 水平与患者预后之间的关联.
- 为了确定非心脏手术中手术内输血的最佳Hb标.
- 支持基于证据的血液管理策略在手术环境中.
主要方法:
- 追溯分析了7528名接受心脏外科手术并进行手术内输血 (2012-2018) 的成年患者.
- 根据手术后的初始Hb水平 (例如,<75g/L,75-85g/L等) 将患者分为6组. ) 的情况.
- 多变量回归分析评估了住院时间,死亡率,违背医疗建议出院,以及急性缺血性损伤的发生率.
主要成果:
- 术后初始Hb<75g/L与显著增加住院时间,死亡率 (OR=2.562) 和违背医疗建议出院 (OR=1.681) 相关.
- 在75-85g/L之间的Hb水平显示出停留时间和急性缺血性损伤发病率增加 (OR=1.778).
- 在初始Hb和影响术后停留时间的手术类型之间发现了显著的相互作用.
结论:
- 术后初始Hb<85g/L与输血非心脏手术患者的预后较差有关.
- 经手术后Hb水平超过一定的值,不会带来额外的好处.
- 术后初始Hb的目标范围为85-95g/L可能代表了手术内输血的合理目标.
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