在选择性和紧急胆囊切除术中进行手术前组和保存测试:经济和环境负担
Max Moss1, Areen Hassan Haleem2, Aiman Ibrahim3
1Trauma and Orthopaedics, Royal Bolton Hospital, Bolton, GBR.
Cureus
|December 9, 2025
概括
在胆囊切除术前进行常规组和保存 (G&S) 测试是不必要的. 很少有患者需要输血,这使得G&S测试昂贵且对环境造成负担.
科学领域:
- 手术手术手术手术手术手术手术手术手术手术
- 临床病理学 临床病理学
- 医疗保健经济学 医疗保健经济学
背景情况:
- 胆囊切除术是一种常见的选择性手术,通常作为一天的病例进行,并在同一天排出.
- 在胆囊切除术期间,外科手术期间的出血和输血需求并不频繁.
- 为胆囊切除术进行常规的手术前组和保存 (G&S) 测试会产生重大经济和环境成本.
研究的目的:
- 确定接受手术前G&S检测的胆囊切除术患者的比例.
- 评估经过胆囊切除术的患者手术前输血的发生率.
- 评估在这个手术群体中进行常规G&S测试的必要性和影响.
主要方法:
- 在两年内对755个成年胆囊切除手术 (可选和紧急) 的回顾性分析.
- 数据收集包括美国麻醉学会 (ASA) 级别,手术紧急情况和G&S测试频率.
- 记录了外科手术期间红细胞输血的发生率和由于出血而需要重新手术的发生率.
主要成果:
- 755名患者接受了胆囊切除术,92.7%是选择性手术.
- 总共提交了1,422个G&S样本;64%的患者有两个样本,12%有两个以上.
- 只有一名患者需要输血红细胞;两名患者因出血相关贫血而返回剧院.
结论:
- 常规的手术前G&S检测不适用于胆囊切除术,因为输血率低.
- 不必要的G&S测试会导致大量的财务支出 (约. 24,000英) 和实验室工作量 (2480小时).
- 对胆囊切除术的选择性G&S测试策略提供经济效益,并支持NHS的可持续性目标.
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