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恶性上消化道和胰腺切除术患者采用限制性输血方案可减少输血,且不增加患者发病率。

Restrictive blood transfusion protocol in malignant upper gastrointestinal and pancreatic resections patients reduces blood transfusions with no increase in patient morbidity.

作者信息

Wehry John, Agle Steven, Philips Prejesh, Cannon Robert, Scoggins Charles R, Puffer Lisa, McMasters Kelly M, Martin Robert C G

机构信息

Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.

Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA.

出版信息

Am J Surg. 2015 Dec;210(6):1197-204; discussion 1204-5. doi: 10.1016/j.amjsurg.2015.08.013. Epub 2015 Sep 30.

Abstract

BACKGROUND

The purpose of this study was to determine the impact of a restrictive blood transfusion protocol on the number of transfusions performed and the related effect on patient morbidity.

METHODS

A cohort study was performed using our prospective database with information from January 1, 2000, to June 1, 2013. The restrictive blood transfusion protocol was implemented in September 2011, so this date served as the separation point for the date of operation criteria.

RESULTS

For the study, 415 patients undergoing operation for an abdominal malignancy were reviewed. After the restrictive blood transfusion protocol, the percentage of patients who received blood dropped from 35.6% to 28.3%. The percentage of patients who experienced perioperative complication was significantly higher in transfused patients compared with those who did not receive blood (P = .0001). There was no statistical significance observed between the 5 groups for the length of stay at the hospital after their procedure.

CONCLUSIONS

The restrictive blood transfusion protocol resulted in a reduction of the percentage of patients transfused, and there was no evidence to suggest that it negatively affected the outcomes of patients in this group.

摘要

背景

本研究的目的是确定限制性输血方案对输血次数的影响以及对患者发病率的相关影响。

方法

利用我们的前瞻性数据库进行队列研究,该数据库包含2000年1月1日至2013年6月1日的信息。限制性输血方案于2011年9月实施,因此该日期作为手术标准日期的分隔点。

结果

本研究对415例接受腹部恶性肿瘤手术的患者进行了回顾。实施限制性输血方案后,接受输血的患者比例从35.6%降至28.3%。与未接受输血的患者相比,接受输血的患者围手术期并发症发生率显著更高(P = .0001)。五组患者术后住院时间之间未观察到统计学差异。

结论

限制性输血方案导致输血患者比例降低,且没有证据表明该方案对该组患者的预后有负面影响。

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