论文部分内容阅读
目的对我国红细胞输血阈值的研究结果进行荟萃分析,评估《临床输血技术规范》“手术及创伤输血指南”和“内科输血指南”的安全性、经济性、实用性和有效性。方法检索中国知网、维普中文科技期刊数据库、万方医学网1998年1月-2015年6月,国内公开发表的患者采用限制性红细胞输血策略与开放性红细胞输血策略的临床效果进行对比分析的期刊文献,观察对象≥16周岁,临床观察指标包括:调查人数、性别、年龄、输血量、输血人数、术后感染率、死亡率、APACHEⅡ评分、ICU住院时间、住院时间、心力衰竭发生率、器官衰竭数量、多器官功能衰竭评分、干预措施前后平均Hb值等定量指标。采用Cochrane协作网出品的Review Manager 5.3(Rev Man 5.3)分析软件进行统计学分析。结果 12篇RCT论文纳入研究,1 796例病例。实施限制性红细胞输血策略的输血量[SMD=-1.12,95%CI(-1.55,-0.70),P<0.01]、输血人数[RR=0.57,95%CI(0.51,0.64),P<0.01]、术后感染率[RR=0.80,95%CI(0.70,0.92),P<0.01]、ICU住院天数[SMD=-0.35,95%CI(-0.53,-0.18),P<0.01]、心力衰竭率[RR=0.72,95%CI(0.61,0.86),P<0.01],均明显低于开放性红细胞输血策略。结论国内研究的结果证实《临床输血技术规范》的“手术及创伤输血指南”和“内科输血指南”是安全、经济、实用、有效的。
Objective To evaluate the safety, economy, practicability and validity of “Clinical Transfusion Specifications”, “Guidelines for Transfusion of Surgical and Traumatic Trauma” and “Guidelines for Transfusion of Internal Medicine” for the research results of erythrocyte transfusion threshold in our country. METHODS: The published published data from January 1998 to June 2015 were compared with the clinical data of restricted red blood cell transfusion strategy and open transfusion strategy of red blood cells in China. Journal articles, observational objects ≥16 years of age, clinical observation indicators include: the number of the survey, gender, age, blood transfusion, blood transfusion, postoperative infection rate, mortality, APACHE Ⅱ score, ICU length of stay, hospital stay, the incidence of heart failure, The number of organ failure, multiple organ failure scores, mean Hb before and after intervention and other quantitative indicators. The Cochrane Collaboration’s Review Manager 5.3 (Rev Man 5.3) analysis software was used for statistical analysis. Results 12 RCT papers were included in the study and 1 796 cases were included. The number of blood transfusions [RR = 0.57, 95% CI (0.51, 0.64), P <0.01, P <0.01] ], Postoperative infection rate [RR = 0.80,95% CI (0.70,0.92, P <0.01], ICU length of stay [SMD = -0.35,95% CI (-0.53, -0.18), P <0.01] The rate of heart failure [RR = 0.72, 95% CI (0.61, 0.86), P <0.01] was significantly lower than that of the open transfusion strategy. Conclusion The results of domestic studies confirm that the Guidelines for Transfusion of Surgical and Traumatic Trauma and the Guidelines for Transfusion of Internal Medicine are safe, economical, practical and effective.