术前静脉输入与口服铁补充剂用于选择性手术:基于12项随机试验的证据
Lei Yue1, Jianming Zhang1, Chao Li1
1Orthopaedic Department, Peking University First Hospital, Beijing, China.
Postgraduate medicine
|January 16, 2025
概括
术前静脉注射铁补充剂 (IVIS) 与口服铁 (OIS) 相比,可选手术患者的血红蛋白和费里丁水平显著增加. 然而,IVIS增加疼痛,但不增加输血需求,这表明个性化铁疗法至关重要.
科学领域:
- 血液学 血液学 血液学
- 临床医学 临床医学
- 手术患者护理手术患者护理
背景情况:
- 在选择性手术患者中,术前贫血很常见.
- 铁补充剂用于纠正手术前的贫血.
- 静脉铁补充剂 (IVIS) 和口服铁补充剂 (OIS) 是常见的方法.
研究的目的:
- 在选择性手术患者中,比较术前IVIS与OIS的疗效和安全性.
- 分析血液学参数,输血要求和不良事件.
主要方法:
- 在多个数据库中进行了系统的文献搜索,直到2023年12月.
- 包括12项随机对照试验 (RCT),涉及930名参与者.
- 数据合成使用随机效应模型,评估血红蛋白水平,费里丁,达到率,输血需求和不良事件.
主要成果:
- 与OIS相比,IVIS在治疗后显著改善了血红蛋白 (MD=0.77 g/dL) 和费里丁水平 (MD=260.03 ng/mL).
- IVIS导致更高的血红蛋白达到率 (RR=1.88),但没有显著改变输血率.
- IVIS与消化系统不良事件较少相关,但与疼痛相关的事件较多.
结论:
- 与OIS相比,IVIS在改善选择性手术患者的血液学参数方面表现出更高的疗效.
- 虽然IVIS减少了消化系统的副作用,但它与疼痛增加有关. 输血需求并没有显著不同.
- 建议个性化选择铁补充剂,考虑疗效和不良事件概况.
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