妇科肿瘤学家输血实践的一项调查。

Price F V, Kelley J L, Edwards R P, Hasley P B, Amin R M

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pennsylvania 15213, USA.

Gynecol Oncol. 1995 Oct;59(1):45-50. doi: 10.1006/gyno.1995.1266.

OBJECTIVE

To survey the attitudes of gynecologic oncologists about indications for blood transfusion, and compare them to current recommendations about transfusion practice.

METHODS

With the permission of the Society of Gynecologic Oncologists (SGO), a study questionnaire was mailed to 548 members and candidates in their directory. The questions asked about transfusion threshold before chemotherapy, following ovarian debulking, and after endometriosis surgery. Indications for transfusion were assessed using a qualitative/quantitative scale. Responses were analyzed with respect to years of SGO membership and practice setting using the chi 2 test and analysis of variance. Results were compared to the 1992 guidelines for transfusion of the American College of Physicians (ACP).

RESULTS

Two hundred eighty-five forms were returned (52% of total). Fifty-one percent of respondents were in full-time academic positions; 36% were in private practice. Sixty-one percent were full SGO members, and 35% were candidates. The average prechemotherapy transfusion threshold (TT) was a hemoglobin concentration (hgb) of 7.9 +/- 0.7 g/dl (g). At that level the mean transfusion was 1.9 +/- 0.5 units of packed red blood cells (U). For the ovarian debulking scenario, the mean postoperative TT was 8.1 +/- 0.8 g with a mean transfusion of 1.9 +/- 0.4 U. For the endometriosis case, the mean TT was 7.0 +/- 0.8 g, with a mean transfusion of 1.9 +/- 0.5 U. Analysis showed no difference in practice based on years of SGO membership or practice setting.

CONCLUSION

A majority of the gynecologic oncologists surveyed offers transfusion at levels of anemia similar to ACP recommendations, but frequently transfuse more units than recommended. A substantial minority does not follow the guidelines at all.

目的

调查妇科肿瘤学家对输血指征的态度，并将其与当前关于输血实践的建议进行比较。

方法

经妇科肿瘤学家协会（SGO）许可，向其名录中的548名成员和候选人邮寄了一份研究问卷。问题涉及化疗前、卵巢肿瘤细胞减灭术后以及子宫内膜异位症手术后的输血阈值。使用定性/定量量表评估输血指征。采用卡方检验和方差分析，就SGO会员年限和执业环境对回复进行分析。将结果与美国医师协会（ACP）1992年的输血指南进行比较。

结果

共收回285份问卷（占总数的52%）。51%的受访者为全职学术职位；36%为私人执业。61%为SGO正式会员，35%为候选人。化疗前的平均输血阈值（TT）为血红蛋白浓度（hgb）7.9±0.7 g/dl（克）。在该水平，平均输血量为1.9±0.5单位浓缩红细胞（U）。对于卵巢肿瘤细胞减灭术的情况，术后平均TT为8.1±0.8 g，平均输血量为1.9±0.4 U。对于子宫内膜异位症病例，平均TT为7.0±0.8 g，平均输血量为1.9±0.5 U。分析表明，基于SGO会员年限或执业环境，实践中不存在差异。