摘要
目的探讨血小板输注对心脏病患者术后医院感染(healthcare-associated infections,HAIs)亚型及其对手术死亡结局的影响。方法检索Cochrane Library、PubMed、Web of Science、Embase、维普网、中国知网及万方数据知识服务平台在2005年1月至2025年1月期间发表的关于心脏手术患者血小板输注后HAIs和死亡结局的队列研究,共纳入16篇文献,配对和非配对研究分别为7项、9项,对数据进行Meta分析。结果血小板和非血小板输注各占41.7%、58.3%。Meta分析结果显示,与非血小板输注患者相比,血小板输注患者的HAIs、医院获得性肺炎(hospital-acquired pneumonia,HAP)和手术死亡的发生率明显更高。但配对研究数据发现血小板输注仅增加HAP发生风险(RR=2.23,95%CI:1.06~4.70,P=0.030)。结论围术期血小板输注仅对成年心脏病患者术后HAP存在显著影响,对心脏病患者术后结局无不良影响。
Objective To investigate the effect of platelet transfusion on the subtypes of postoperative healthcare-associated infections(HAIs)and the outcome of surgical mortality in patients with heart disease.Methods Literatures were searched in Cochrane Library,PubMed,Web of Science,Embase,VIP,CNKI and Wanfang Data Knowledge Service Platform database for cohort studies from January 2005 to January 2025 regarding HAIs and mortality outcomes after platelet transfusion in cardiac surgery patients.A total of 16 literatures were included,with 7 paired and 9 unpaired studies.Meta-analysis was conducted on the data.Results Platelet transfusion and non-platelet transfusion comprised 41.7%and 58.3%of cases respectively.Meta-analysis revealed significantly higher rates of HAIs,hospital-acquired pneumonia(HAP),and surgical mortality in platelet transfusion patients compared to non-platelet transfusion patients.However,paired study data indicated that platelet transfusion only increased the risk of HAP(RR=2.23,95%CI:1.06-4.70,P=0.030).Conclusion Platelet transfusion during the perioperative period only had a significant effect on postoperative HAP in adult patients with heart disease,and had no adverse effect on postoperative outcome in patients with heart disease.
作者
刘冬冬
彭莲华
郭小草
黄玲
肖瑾瑛
LIU Dongdong;PENG Lianhua;GUO Xiaocao;HUANG Ling;XIAO Jinying(Cardiothoracic and Vascular Surgery,Affiliated Hospital of Jinggangshan University,Jian 343000,Jiangxi,China;Hospital Infection Prevention and Control Department,Affiliated Hospital of Jinggangshan University,Jian 343000,Jiangxi,China)
出处
《中国现代医生》
2025年第35期22-26,共5页
China Modern Doctor
基金
江西省吉安市科技计划专项(20211-115559)
吉安市科技计划指导性项目(20255-031105)。
关键词
血小板输注
心脏手术
医院感染
META分析
Platelet transfusion
Cardiac surgery
Healthcare-associated infection
Meta analysis
