Ransom S B, McNeeley S G, Hosseini R B
Division of Gynecologic Surgery, Hutzel Hospital/Wayne State University School of Medicine, Detroit, Michigan, USA.
Obstet Gynecol. 1995 Sep;86(3):346-8. doi: 10.1016/0029-7844(95)00187-V.
To evaluate the usefulness and cost-effectiveness of the routine preoperative evaluation of blood type and screen testing before laparoscopy.
A retrospective review was conducted in patients transfused with blood during or after laparoscopy over a 3-year period at Hutzel Hospital, Detroit, Michigan; Grace Hospital, Southfield, Michigan; and Bixby Medical Center, Adrian, Michigan.
Of 7529 women receiving laparoscopic procedures, 57 required blood transfusion at laparoscopy. Medical records of the 57 patients requiring blood transfusion were evaluated as to urgency and indication. All 57 subsequent blood transfusions were found to be the result of previously identifiable problems, including ectopic pregnancy and preoperative anemia. No patient required transfusion for a vascular injury.
In the absence of preoperative indications, routine preoperative type and screen testing for elective and emergency laparoscopic procedures does not enhance patient care and should be eliminated.
评估腹腔镜手术前常规血型鉴定和筛查试验的实用性及成本效益。
对密歇根州底特律市胡茨尔医院、密歇根州南菲尔德市格雷斯医院以及密歇根州阿德里安市比克斯比医疗中心在3年期间接受腹腔镜手术期间或术后输血的患者进行回顾性研究。
在7529例接受腹腔镜手术的女性中，57例在腹腔镜手术时需要输血。对这57例需要输血患者的病历进行了紧急程度和输血指征评估。发现所有57例后续输血均为先前可识别问题所致，包括异位妊娠和术前贫血。没有患者因血管损伤而需要输血。
在没有术前指征的情况下，择期和急诊腹腔镜手术的常规术前血型鉴定和筛查试验并不能改善患者护理，应予以取消。
