在产后出血多学科管理评估之前和之后的回顾
Jarmila Anna Zdanowicz1, Sophie Schneider1, Carla Martignoni1
1Department of Obstetrics and Gynecology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Journal of clinical medicine
|December 9, 2023
概括
实施产后出血 (PPH) 指南减少了红细胞 (RBC) 输血和血液静止产品的使用. 这项研究表明,指导方针改善了PPH管理,降低了母亲的风险.
科学领域:
- 产科和妇科 产科和妇科
- 血液学 血液学 血液学
- 医疗保健管理的管理
背景情况:
- 产后出血 (PPH) 是导致产妇死亡的主要原因.
- 现有的PPH治疗指南缺乏关于它们对输血产品和血液静止剂使用的影响的数据.
- 对PPH管理的持续评估对于确定改进领域和整合新疗法至关重要.
研究的目的:
- 追溯地比较PPH管理实践和红细胞 (RBC) 和静血产品在国际准则实施之前和之后的管理.
- 评估指南实施对红细胞输血率的影响,血红蛋白引发输血,静血产品的使用,以及对PPH的手术干预.
主要方法:
- 2011年与2018年管理的PPH病例的回顾性比较.
- 分析了235名患有PPH的患者的数据 (2011年为59人,2018年为176人).
- 主要终点:对PPH的红血细胞给药;次要终点:对红血细胞,血静产品和外科治疗的血红蛋白触发.
主要成果:
- 与2011年相比,2018年接受红血细胞的患者较少 (10%与24小时内32%相比,p < 0.001;24小时后4.5%与37%相比,p < 0.001).
- 每个PPH病例输血的红细胞单位的平均数量在2018年显著下降 (2个单位比4个单位,p = 0.013).
- 2018年观察到新鲜冷血 (p < 0.001) 和血小板 (p = 0.002) 输血的显著减少,同时较少使用PPH的额外手术.
结论:
- 地方实施多学科PPH指南是可行的.
- 准则的实施与红细胞和其他血液制品输血对PPH的显著减少有关.
- 这些发现表明,标准化的PPH管理协议可以优化资源利用率并改善患者的治疗结果.
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