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在 laparoscopic 尾切除术之前进行常规组和保存 (G + S) 测试:为期10年的单中心审查

Oday Al-Asadi¹, Mostafa Mahran², Roham Karimi¹

¹General Surgery, Homerton University Hospital, London, GBR.

|December 18, 2025

概括

在腹腔镜尾切除术前进行例行组和保存 (G+S) 测试对大多数患者来说在临床上是不必要的,提供最小的益处,并产生显著的成本. 对高风险个体的选择性方法可以保持安全,同时减少资源使用.

科学领域:

手术瘤学手术瘤学
输血医学输血医学
卫生经济学卫生经济学

背景情况:

在英国,腹腔镜尾切除术前,常规的手术前组和保存 (G+S) 测试被广泛实践.
支持G+S在这种患者群体中的必要性的证据有限.
这项研究调查了G + S在腹腔镜尾切除术中的临床实用性和成本效益,超过十年.

研究的目的:

评估在经过腹腔镜尾切除手术的患者中进行常规手术前组和保存 (G+S) 测试的临床需要.
评估G+S测试在这种手术环境中的成本效益.
为了确定腹腔镜尾切除术患者术前输血的频率和原因.

主要方法:

一项为期10年的回顾性队列研究,包括1733名接受腹腔镜尾切除术的患者.
分析电子记录以确定术后输血及其指示 (手术与非手术).
将输血率与已发表的文献进行比较,并对常规G+S测试的成本分析.

主要成果:

只有0.29%的患者接受了输血,只有0.12%是由于术后手术出血.
大多数输血是出于非手术原因,例如潜在的医疗条件.
针对所有患者的常规G+S测试带来了巨大的成本 (26,000英-36,500英),临床收益最小.

结论:

常规的手术前G + S测试为经历腹腔镜尾切除术的低风险患者提供了最小的临床益处.
这种做法意味着不必要地使用医疗保健资源.
建议采用选择性,基于风险的G + S测试方法,以优化患者安全并降低成本.

关键词:

流血和血液制品的使用降低成本降低成本进行组与保存测试.医疗保健信任基金会医疗保健信任基金会腹腔镜急诊手术腹腔镜急诊手术

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