在外科手术期间进行血液管理
Shruti Parikh1, Taylor Bentz1, Samuel Crowley1
1Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Journal of clinical medicine
|June 13, 2025
概括
通过治疗贫血和尽量减少血液损失,患者血液管理优化了手术结果. 这种方法使用基于证据的指导方针来提高患者的安全性,减少输血,并在整个术后期降低成本.
科学领域:
- 麻醉学 麻醉学
- 血液学 血液学 血液学
- 手术患者护理手术患者护理
背景情况:
- 贫血在手术前经常被忽视和治疗不充分,这会影响患者的治疗结果.
- 患者血液管理 (PBM) 为优化手术患者提供了一个框架.
研究的目的:
- 审查外科手术期间血液产品管理策略.
- 突出早期贫血纠正的重要性以及基于证据的输血指南.
主要方法:
- 讨论PBM原则,包括贫血管理,减少血液损失和凝血病治疗.
- 审查自由与限制性输血策略和血红蛋白值.
- 包括手术内粘弹性测试 (例如,旋转血栓弹性测试,血栓弹性测试) 进行实时凝血分析.
主要成果:
- PBM旨在提高患者安全,减少输血并发症,降低医疗保健成本.
- 对于稳定的患者 (7-8 g/dL) 和心脏病患者 (>8 g/dL) 存在特定的输血值.
- 粘弹性测试指导针对性输血的血液制品和抗纤维素溶解药物.
结论:
- 综合的外科手术期间血液管理对于手术患者的护理至关重要.
- 治疗贫血并采用基于证据的策略,可以最大限度地减少血液损失和输血风险.
- 血液制品的有效管理提高了患者的治疗结果,并降低了整体成本.
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