术后输血和全关节和膝关节整形手术中的不良事件:基于TrinetX的分析
Hsien-Hsu Hsieh1,2, Jun-Hong Lin3, Huey-En Tzeng3,4,5
1Division of General Laboratory, Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Frontiers in medicine
|February 9, 2026
概括
在膝关节或关节完全置换后进行外科手术期间的全基因输血会增加感染,血栓和死亡的风险. 节约血液的策略对于患者的安全和更好的结果至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 输血医学 输血医学
- 患者安全 患者安全
背景情况:
- 全球预期寿命的增加导致与年龄相关的疾病的发病率上升,包括骨关节炎.
- 全膝关节整形术 (TKA) 和全关节整形术 (THA) 是晚期关节炎的常见治疗方法.
- 术后输血和输血仍然是关节置换手术中的重要问题.
研究的目的:
- 为了研究术前全基性输血和术后不良结果之间的关联.
- 分析与TKA和THA患者输血相关的风险.
- 在骨科手术中为患者提供血液管理策略的信息.
主要方法:
- 使用 TriNetX 全球研究数据库进行回顾性队列研究.
- 对323,669例TKA或THA病例 (2019年1月至2024年9月) 的分析.
- 倾向性得分匹配创建了2,040对对比输血与非输血组;评估的结果包括感染,血栓栓塞和30天死亡率.
主要成果:
- 在外科手术期间,0.63%的病例发生了全基性输血.
- 输血显著增加了30天不良结果的风险:术后输血 (HR=9.67),感染 (HR=3.82),败血症 (HR=2.30),DVT (HR=2.20) 和死亡率 (HR=2.90).
结论:
- 在外科手术期间输血与TKA/THA后更高的并发症和死亡率有关.
- 这些发现凸显了患者血液管理和血液保存技术的必要性.
- 尽量减少输血可以提高安全性,减少关节置换手术中的不良事件.
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