在产后贫血中,单片或两片输血:在回顾性队列中确定预测因素
Chen Ben David1, Inbal Or2, Roee Iluz1
1Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel.
概括
产科医生讨论了产后贫血 (PPA) 的单单或两单元协议. 这项研究发现没有独立的预测因子需要两个单位的包装红细胞 (pRBC),强调个性化重新评估.
科学领域:
- 产科和妇科 产科和妇科
- 输血医学 输血医学
- 麻醉学 麻醉学
背景情况:
- 产后贫血 (PPA) 管理涉及对包装红细胞 (pRBC) 进行辩论的单个或两单元协议.
- 在一项先前的试验中,单单元方法在80%的患者中预防了第二次输血.
- 确定可能受益于前期两单元协议的患者仍未确定.
研究的目的:
- 在患有产后贫血 (PPA) 的妇女中,确定与需要两单位包装红细胞 (pRBC) 输血协议相关的风险因素.
主要方法:
- 回顾性队列研究 (2013-2023年) 包括接受pRBC输血的PPA妇女.
- 排除了血液动力学不稳定的患者.
- 对单单元和两单元pRBC输血组之间的结果进行比较,以确定两单元协议的风险因素.
主要成果:
- 分析包括368名女性 (单个单位) 和317名 (两个单位).
- 单变量分析确定了剖腹产的持续时间,表皮切割,最低分娩后血红蛋白和平均血红蛋白三角值作为两单元输血的显著风险因素.
- 多变量分析显示,对于需要两个prbc来说,没有显著的独立预测因素.
结论:
- 在这个队列中,没有确定需要两个单位的PRBC的独立预测因子.
- 对于pRBC输血的临床决策显示出可变性,支持在每个单位后重新评估.
- 遵守输血指南可以降低与pRBCs相关的成本和发病率.
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