重新评估在门诊整形外科外围四肢创伤手术中进行组和保存测试的必要性
Max Moss1, Conor Boylan2, Success Anyanwu1
1Trauma and Orthopaedics, Royal Bolton Hospital, Bolton, GBR.
Cureus
|December 15, 2025
概括
常规的手术前组和保存 (G&S) 测试对于门诊骨科创伤手术往往是不必要的,导致显著的成本. 选择性,基于风险的协议可以提高骨科护理的效率和可持续性.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 卫生经济学 卫生经济学
背景情况:
- 术前组和保存 (G&S) 测试在门诊骨科创伤手术中很常见,因为人们担心血液损失.
- 目前的协议往往含糊不清,导致潜在的不必要的测试,增加成本和环境影响.
研究的目的:
- 为了确定红细胞输血的发病率在成人患者接受门诊外围四肢创伤手术.
- 量化手术前G&S测试的流行率.
- 为了确定与G&S测试相关的患者和程序因素.
主要方法:
- 成年患者的回顾性队列研究,这些患者接受了远程骨科手术,距离肩膀和膝盖.
- 收集的数据:患者人口统计,G&S测试发生率,外科手术期间红细胞输血率.
- 统计分析:单变量和多变量模型来识别G&S测试的预测因素.
主要成果:
- 459名患者中有34.3%接受了G&S检测;没有患者接受了手术后输血.
- 脚手术的G&S测试率很高 (62.6%).
- 更高的ASA等级和软骨/肩膀手术增加了G&S测试的可能性;上肢手术降低了它. 没有发现人口统计学意义.
结论:
- 在许多门诊外围四肢整形外伤患者中,常规的手术前G&S测试在临床上并不必要.
- 检测实践受到手术部位和患者共患病 (ASA等级) 的影响,导致不必要的成本.
- 需要一个选择性,基于风险的协议,以使实践与证据保持一致,提高成本效益,提高可持续性.
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