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围手术期异体输血与胃癌手术患者更差的临床结局相关:一项荟萃分析。

Perioperative Allogenenic Blood Transfusion is Associated With Worse Clinical Outcome for Patients Undergoing Gastric Carcinoma Surgery: A Meta-Analysis.

作者信息

Li Lihong, Zhu Dajian, Chen Xiaowu, Huang Yanfeng, Ouyang Manzhao, Zhang Weijie

机构信息

From the Department of General Surgery I, First People's Hospital of Shunde, Foshan City, Guangdong Province, China.

出版信息

Medicine (Baltimore). 2015 Sep;94(39):e1574. doi: 10.1097/MD.0000000000001574.

Abstract

Whether perioperative allogenic blood transfusion (ABT) has adverse effect on patients with gastric carcinoma (GC) surgery or not, that is controversial. Our study evaluated the association between ABT and some clinical outcomes of GC surgery patients. Data of relevant studies were based on PubMed, EMBASE, and the Cochrane Library search. The relative risk (RR) of 5-year survival rates, tumor recurrence, and postoperative complications were performed; subgroup analyses included district, transfusion rates, age, participants, sex, and tumor stage. The study was approved by the ethics committee of the First People's Hospital of Shunde. In total, 9189 participants from 16 studies were included in the meta-analysis. The 5-year survival rate was decreased for the GC patients with ABT (RR = 0.74, 95% confidence interval [CI] = 0.69-0.79), the risk of tumor recurrence was significantly higher for ABT patients (RR = 1.82, 95% CI = 1.32-2.51), and postoperative complications increased in ABT patients (RR = 1.36, 95% CI = 1.02-1.81), respectively; in subgroup analyses, 5-year survival rates were not associated with the transfusion rates (χ2 = 0.37, P = 0.54). Transfusion for patients undergoing GC surgery, even low transfusion rates, would reduce the 5-year survival rates, and elevated the risk of tumor recurrence and postoperative complication.

摘要

围手术期异体输血(ABT)对胃癌(GC)手术患者是否有不良影响,这存在争议。我们的研究评估了ABT与GC手术患者一些临床结局之间的关联。相关研究数据基于PubMed、EMBASE和Cochrane图书馆检索。对5年生存率、肿瘤复发和术后并发症的相对风险(RR)进行了分析;亚组分析包括地区、输血率、年龄、参与者、性别和肿瘤分期。该研究得到了顺德区第一人民医院伦理委员会的批准。总共16项研究中的9189名参与者被纳入荟萃分析。接受ABT的GC患者5年生存率降低(RR = 0.74,95%置信区间[CI] = 0.69 - 0.79),ABT患者肿瘤复发风险显著更高(RR = 1.82,95% CI = 1.32 - 2.51),且ABT患者术后并发症增加(RR = 1.36,95% CI = 1.02 - 1.81);在亚组分析中,5年生存率与输血率无关(χ2 = 0.37,P = 0.54)。GC手术患者输血,即使是低输血率,也会降低5年生存率,并增加肿瘤复发和术后并发症的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/808b/4616838/2b6c5d031f28/medi-94-e1574-g005.jpg

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