回顾性调查英国和美国的产科红细胞输血实践。

Retrospective surveys of obstetric red cell transfusion practice in the UK and USA.

机构信息

Academic Department of Obstetrics and Gynaecology, Imperial College London, London, UK.

Department of Obstetrics, Chelsea and Westminster Hospital, London, UK.

出版信息

Int J Gynaecol Obstet. 2017 Dec;139(3):342-345. doi: 10.1002/ijgo.12309. Epub 2017 Sep 13.

DOI:10.1002/ijgo.12309

PMID:28833097

Abstract

OBJECTIVE

To examine whether professional guidance promoting a policy of restrictive blood transfusion is being followed.

METHODS

A retrospective analysis of post-delivery transfusion data from 17 maternity units in the UK (1988-2000) was undertaken. Additionally, an audit was performed of women receiving one or two units of red cells 6-24 hours after delivery at three centers in the UK and USA in 2013-2016.

RESULTS

Between 1988 and 2000, 4700 women received one or two transfusions: 303 (6.4%) received one unit and 4397 (93.6%) received two. Median estimated blood loss (EBL) was similar in both groups (600 mL [IQR 400-1000] vs 700 mL [IQR 400-1000], respectively; P=0.862]. Between 2013 and 2016, 41, 22, and 64 women received one or two units during transfusion at centers A, B, and C, respectively. Two units were transfused for 40 (97.6%) of the women in center A, 21 (95.5%) at center B, and 58 (90.6%) at center C. Median EBL was similar, irrespective of whether one or two units were given.

CONCLUSION

Current transfusion practice deviates from evidence-based guidelines. Either by default or longstanding tradition, more women receive two rather than one unit despite similar EBL.

摘要

目的

考察是否遵循了促进限制性输血政策的专业指导。

方法

对英国 17 家产科单位（1988-2000 年）产后输血数据进行回顾性分析。此外，对英国和美国的 3 个中心的 2013-2016 年产后 6-24 小时内接受 1 或 2 单位红细胞的妇女进行了审计。

结果

1988 年至 2000 年期间，4700 名妇女接受了 1 或 2 次输血：303 名（6.4%）接受了 1 单位，4397 名（93.6%）接受了 2 单位。两组的中位估计失血量（EBL）相似（分别为 600ml[IQR 400-1000]和 700ml[IQR 400-1000]；P=0.862）。2013 年至 2016 年期间，A、B、C 中心在输血期间分别有 41、22、64 名妇女接受了 1 或 2 单位输血。A 中心有 40 名（97.6%）妇女输注 2 单位，B 中心有 21 名（95.5%），C 中心有 58 名（90.6%）。无论输注 1 单位还是 2 单位，EBL 中位数相似。