在肝移植手术中评估是否需要进行常规的手术内细胞救援
Claudianne Maia de Farias Lima1, Tatyane Oliveira Rebouças1, Luciana Maria de Barros Carlos1
1Centro de Hematologia e Hemoterapia do Ceará - Fortaleza (CE), Brazil.
Acta cirurgica brasileira
|December 6, 2023
概括
在所有肝移植中,常规的细胞救援并不是必要的. 它的使用最适用于患有门静脉血栓症和异常肌水平的患者,优化资源配置.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 麻醉学 麻醉学
背景情况:
- 肝移植是一种复杂的手术,有可能导致大量的血液损失.
- 术内细胞救援 (ICS) 是一种在手术期间丢失的患者自己的血液的回收和再注入的技术.
- 在肝移植中常规ICS的必要性仍然是争论的主题.
研究的目的:
- 评估肝移植接受者的常规手术内细胞救援的必要性和影响.
- 确定在肝移植期间从细胞救援中最能受益的特定患者子组.
主要方法:
- 对2014年至2016年期间进行的327次肝移植进行了回顾性分析.
- 数据收集包括移植前因素,手术内红细胞输血和手术细节.
- 移植与没有细胞救援利用之间的结果的比较.
主要成果:
- 在34%的病例中,需要全基红细胞输血.
- 在73%的移植中使用细胞救援,在93%的病例中成功恢复.
- 恢复血量大于200毫升的患者不需要异构输血;然而,在没有细胞挽救的移植中,19.1%的患者也不需要输血.
结论:
- 在所有肝脏移植中,常规的手术内细胞救援并不总是必要的.
- 细胞挽救的具体指示包括患有门静脉血栓症和肌素水平升高的患者.
- 选择性地使用细胞救援可以优化肝移植中的资源利用.
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