摘要
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 analyze research outcome of red blood cell transfusion thresholds using meta-analysis in China,to evaluate the safety,economic feasibility,practicality and effectiveness of＂Guideline on Surgery and Trauma Transfusion＂and ＂Guideline on Medical Transfusion＂. Methods Trials were identified by computer searches of CNKI. NET,VIP China Science and Technology Journal Database,Wangfang Med Online（ from January 1998 to June 2015）. The domestic publication periodical literatures were used to analyze the clinical effect of restrictive or liberal blood transfusion strategies on patients. Targeted populations were ≥16 years old. Clinical observation index included the following： number of people for investigation,gender,age,transfused blood volume,the number that received blood transfusion,the rate of postoperative infection,mortality,APACHEⅡ score,ICU length of stay,hospital length of stay,the rate of heart failure,number of patients with organ failure,multiple organ functional failure score,and average Hb value before and after intervention. Review Manager 5. 3（ Rev Man 5. 3） analysis software manufactured by Cochrane was used for statistical analysis. Results 12 RCT theses were included in the study. There were a total of 1 796 patients. The restrictive red cell transfusion strategies were implemented. The transfused blood volumes were（ SMD =- 1. 12,95% CI（- 1. 55,- 0. 70）,P〈0. 01）. The number of patients receiving blood transfusion was（ RR = 0. 57,95% CI（ 0. 51,0. 64）,P〈0. 01）. The rate of postoperative infection was（ RR = 0. 80,95% CI（ 0. 70,0. 92）,P = 0. 01）. The ICU length of stay was（ SMD =- 0. 35,95% CI（- 0. 53,-0. 18）,P〈0. 01）. The rate of heart failure was（ RR = 0. 72,95%,CI（ 0. 61,0. 86）,P〈0. 01）. These indices were significantly lower than those from liberal red cell transfusion strategies. Conclusion The domestic research results confirm that the use of ＂Guideline on Surgery and Trauma Transfusion＂and＂Guideline on Medical Transfusion guideline＂for clinical blood transfusion was safe,economic,practical and effective.
出处
《中国输血杂志》
CAS
北大核心
2016年第1期74-77,共4页
Chinese Journal of Blood Transfusion
