在肝移植中使用前素复合物缩剂:系统性审查和元分析
Isabella Kojundzic1, Neeki Alavi2, Austin Lam2
1Department of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; University of Ottawa Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
British journal of anaesthesia
|September 13, 2025
概括
在肝移植 (LT) 中使用前素复合缩剂 (PCC) 似乎是安全有效的,与冷血 (FP) 相比. 需要进一步的高质量研究来证实这些发现,用于凝血性出血管理.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 输血医学 输血医学
- 关键的护理关键的护理
背景情况:
- 肝移植 (LT) 往往与大量输血有关.
- 通常使用冷血 (FP),但其疗效和安全性数据不一致.
- 血栓复合缩物 (PCC) 是一些中心用于LT的替代品.
研究的目的:
- 系统地审查和分析PCC在肝移植中使用的疗效和安全数据.
- 在LT患者中比较PCC使用与传统方法的结果.
主要方法:
- 在PROSPERO (CRD#42024561866) 登记的系统审查和元分析.
- 在 MEDLINE,Embase,Cochrane 和 ClinicalTrials.gov 搜索到 2024 年 5 月 30 日.
- 包括成人LT患者的回顾性研究,报告了PCC暴露和临床结果.
- 使用随机效应模型进行聚合效应估计.
主要成果:
- 包括的研究是追溯的;PCC在七项研究中被用于21%的患者.
- 接受PCC治疗的患者患有更严重的手术前凝血病和并发症.
- 当受粘弹性测试算法指导时,PCC使用与减少红细胞和FP暴露有关.
- 安全数据主要受到PCC作为救援疗法的一项大型研究的影响.
结论:
- 目前的证据表明,尽管缺乏随机试验,但PCC的疗效和安全性与LT中的FP相似.
- 需要更高质量的研究来最终评估PCC在管理LT期间的凝血性出血中的作用.
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