手术前纤维素水平和肝移植中的输血:系统性审查
Félix Thibeault1, Guillaume Plourde2, Massine Fellouah3
1Department of Surgery, Université de Montréal, Canada.
Transplantation reviews (Orlando, Fla.)
|October 1, 2023
概括
肝移植患者手术前纤维素水平较高与手术期间出血较少和输血产品较少相关,但与死亡率增加有关. 需要进一步的研究来澄清这些关联.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 血液学 血液学 血液学
背景情况:
- 正位肝移植 (OLT) 是一种复杂的手术,经常因大量出血而复杂化.
- 了解影响术后结果的因素对于改善患者管理至关重要.
研究的目的:
- 系统地审查手术前纤维素水平与手术内输血需求,血液损失和OLT患者的临床结果之间的关联.
主要方法:
- 包括24项关于OLT患者的观察队列研究,报告了手术前纤维素水平和结果.
- 主要结局:手术期间输血红细胞 (RBC). 二次结果:血液损失,任何血液产品输血,术后结果和死亡率.
- 在可行的情况下,使用随机效应模型进行了元分析;结果主要是描述性的报道.
主要成果:
- 手术前纤维素水平升高与手术内红细胞和其他血液产品输血减少有关.
- 较高的纤维素素水平与手术期间血液流失的减少相关.
- 在较高的手术前纤维素水平和较低的整体存活率 (HR 1.50;95% CI 1.23-1.84) 之间发现了显著的关联.
结论:
- 在OLT患者中,手术前纤维素水平较高,与手术内输血较少和血液损失较少有关.
- 尽管手术期间并发症减少,但较高的纤维素素水平与长期死亡率的增加有关.
- 需要进一步的研究来阐明这些复杂的关联,并为临床指导方针提供信息.
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