在接受胆囊切除术的患者中评估常规手术前组和保存测试:回顾性队列研究
Lawrence O'Leary1,2, William B Sherwood1, Michael G Fadel3,4
1Department of General Surgery, West Middlesex University Hospital, London, TW7 6AF, UK.
NIHR open research
|October 30, 2024
概括
在胆囊切除术前进行例行组和保存测试通常是不必要的. 之前对胆结石和某些疾病的紧急诊所预测了输血需求,允许更有针对性的测试和节省成本.
科学领域:
- 手术 手术 手术 术 术
- 血液学 血液学 血液学
- 卫生经济学 卫生经济学
背景情况:
- 在胆囊切除术之前,常规的组和保存 (G&S) 测试是常见的.
- 有证据表明,针对性的手术前检测方法是安全和有效的.
- 这项研究评估了G&S测试频率,输血率和输血需求的预测因素.
研究的目的:
- 在胆囊切除术前评估常规组和保存 (G&S) 测试的必要性.
- 确定需要输血的手术前危险因素.
- 评估G&S常规测试的财务影响.
主要方法:
- 对453名接受胆囊切除术的成年患者进行了回顾性队列研究.
- 对手术前输血 (在30天内) 的健康记录的审查.
- 后勤回归分析以确定输血的预测因素,包括先前因胆结石并发症出院急诊.
主要成果:
- 在外科手术期间输血发生在1.1%的病例.
- 美国麻醉学会 (ASA) 的更高评分,血液恶性瘤和之前的胆结石急诊预测需要输血.
- 每一次先前的急诊增加了输血几率4.6倍 (p=0.019).
- 三次或以上的先前出诊预计需要输血,具有98.0%的特异性.
- 74%的患者进行了手术前的G&S,每年花费约3,800英.
结论:
- 在胆囊切除术前不需要进行常规的手术前组和保存 (G&S) 测试.
- 对于胆结石并发症和并发症的先前紧急医院出院是输血的关键预测因素.
- 选择性测试可以在不损害患者安全的情况下节省大量资金.
关键词:
输血 输血 输血 输血 输血 输血 输血 输血血液类型的测定胆固醇切除术 (cholecystectomy) 是一种切除术.交叉匹配的交叉匹配是可以做到的.胆结石 胆结石 胆结石组建并保存一个组.发生出血 发生出血输入并保存一个类型.更多相关视频
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