在接受化疗或干细胞移植的血液学疾病患者中,单单或双单元输血:系统性审查和元分析
Catalina Herrán-Fonseca1, Laura Jekov2, Carlotta Persaud3
1Department of Medicine, Faculty of Health Sciences, Universidad Autónoma de Bucaramanga, Floridablanca, Colombia.
Transfusion medicine reviews
|November 13, 2024
概括
单个单位红细胞 (RBC) 输血政策 (1-RBC) 减少在接受化疗或干细胞移植的血液病患者中使用的RBC单位. 然而,它与出院时血红蛋白水平的降低有关,而不会影响住院或死亡率.
科学领域:
- 血液学 血液学 血液学
- 输血医学 输血医学
- 在瘤学瘤学.
背景情况:
- 在接受化疗或干细胞移植的血液学疾病患者中,最佳的红细胞 (RBC) 输血策略仍在争论中.
- 目前的做法各不相同,没有明确的共识有利于单单元 (1-RBC) 或双单元 (2-RBC) 输血政策.
研究的目的:
- 在接受化疗或干细胞移植的血液病患者中,比较单单元和双单元红细胞输血政策的疗效和安全性.
- 评估输血政策对血红蛋白水平,资源利用和临床结果的影响.
主要方法:
- 在PubMed,Embase和Cochrane图书馆数据库中进行了系统的文献搜索.
- 风险比率 (RR) 和平均差异 (MD) 使用统计分析软件 (Review Manager和R) 进行了聚合.
- 使用I平方 (I2) 统计学来评估异质性.
主要成果:
- 接受1-RBC治疗的患者在出院时血红蛋白 (Hb) 水平显著降低 (MD -0.41 g/dL),并且每次入院使用的红细胞总单位减少 (MD -0.82 单位).
- 在1-RBC和2-RBC组之间,在住院时间 (MD 0.05天),严重出血 (RR 1.52) 或死亡率 (RR 0.89) 方面没有发现显著差异.
- 与输血相关的不良事件在两组之间没有显著差异.
结论:
- 在接受化疗或干细胞移植的血液病患者中,1-RBC政策与每次入院的红细胞单位利用率降低有关.
- 虽然1-RBC导致出院Hb水平降低,但它不会显著增加长时间住院,严重出血或死亡的风险.
- 这些发现表明,1-RBC可能是优化资源使用的可行策略,而不会损害这一群体的患者安全.
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