在状细胞疾病中进行手术前输血 接受腺切除术的儿童
Sonika Kanotra1, Samuel H Muller2, Jhanvi Kanotra3
1Department of ENT, Government Medical College, Jammu, India.
概括
对于接受腺切除术的状细胞疾病儿童,积极的输血方案在预防术后并发症方面不比保守的更有效. 建议采取保守的方法,以尽量减少输血风险.
科学领域:
- 儿科血液学 儿科血液学
- 手术瘤学手术瘤学
- 输血医学 输血医学
背景情况:
- 接受腺切除术的状细胞疾病 (SCD) 患者面临术后并发症的风险.
- 手术前的输血策略旨在减轻这些风险,保守的和积极的方法之间有争议的有效性.
研究的目的:
- 在接受腺切除术的儿科SCD患者中,系统地审查和元分析保守与积极的手术前输血方案的疗效.
- 为了比较两种方案之间的术后并发症,SCD相关事件和输血相关并发症.
主要方法:
- 在PubMed,EMBASE,Cochrane和Ovid数据库中进行了全面的文献搜索.
- 选择了七篇文章进行系统审查,并根据预先定义的标准将两项受控试验纳入了元分析.
主要成果:
- 在侵略性和保守性输血组之间的初级/二级出血率中没有发现统计学上显著的差异 (p=0.089).
- 与SCD相关的并发症 (血管闭塞危机,急性胸部综合征) 也没有显著差异 (p=0.339).
- 虽然在统计学上不显著,但积极输血组的输血相关并发症率更高.
结论:
- 积极的输血方案 (HbS <30%) 与保守的方案相比,在接受腺切除术的儿科SCD患者中,对术后并发症没有更好的保护.
- 建议采取保守的输血策略,以减少输血相关并发症的整体风险.
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