在接受重大手术的非贫血患者中进行手术前补充铁:系统性审查和元分析
Fabio Vieira Toledo1, Daniel De Carli1, Jose Fernando Amaral Meletti1
1Faculdade de Medicina de Jundiaí (FMJ), Departamento de Anestesiologia, Jundiaí, SP, Brazil.
Brazilian journal of anesthesiology (Elsevier)
|April 6, 2025
概括
在接受大手术的非贫血患者中,手术前补充铁可显著降低输血需求. 静脉注射铁显示明显的好处,但口服铁显然有好处.
科学领域:
- 在外科手术期间的医学.
- 输血医学 输血医学
- 营养科学 营养科学
背景情况:
- 输血增加了患者的发病率和死亡率.
- 全球血液供应维持是一个重大挑战.
- 术前干预对于优化手术结果至关重要.
研究的目的:
- 系统地审查手术前铁补充剂对接受重大手术的非贫血患者输血风险的影响.
- 为了评估补充铁对外科手术期间血红蛋白水平的影响.
主要方法:
- 在PubMed,Embase和Cochrane Central系统搜索随机对照试验,直到2024年5月.
- 排除使用红素或随机化前使用铁的研究.
- 对输血率和平均血红蛋白水平的评估.
主要成果:
- 9项研究包括1162名非贫血患者,54%接受了手术前的铁.
- 补充铁可以显著降低输血风险 (OR = 0.54;p < 0.001).
- 术后第一天的血红蛋白与铁含量较高 (MD = 0.22 g/dL; p = 0.03),但在第一周没有显著差异.
结论:
- 在接受大手术的非贫血患者中,手术前静脉注射铁显著降低了输血需求.
- 口服铁补充剂的益处仍然不确定.
- 对于标准化外科手术期间的铁协议,还需要进一步的研究.
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