摘要
目的 系统评价心脏围术期输血与术后近远期结局的关系。方法 检索中英文文献数据库中1990年1月至2014年12月关于输血和心脏术后结局关系的回顾性病例对照研究,使用Rev Man 5.3软件,应用Meta分析方法对所纳入文献的研究结果进行定量综合分析。结果 本研究共纳入13项回顾性病例对照临床研究,总样本量88 808例,其中输血组42 991例,未输血组45 817例。输血组和未输血组的各心脏术后结局指标差异均有统计学意义:30 d死亡率(OR=2.39,95%CI:1.71-3.34,P〈0.000 01),1年死亡率(OR=3.08,95%CI:2.18-4.35,P〈0.000 01),5年死亡率(OR=1.90,95%CI:1.42-2.56,P〈0.0001),缺血事件(OR=2.23,95%CI:1.71-2.90,P〈0.000 01),感染(OR=2.18,95%CI:1.74-2.75,P〈0.000 01)。结论 围术期输血与心脏手术后近远期死亡率和缺血事件、感染的发生具有明显相关性。
Objective To systematically assess the correlation between blood transfusion and postoperative outcomes following cardiac surgery .Methods Databases were searched for retrospective case-control studies on blood transfusion and postoperative outcome after cardiac surgery published in Chinese and English between January 1990 and December 2014 .A meta-analysis was performed using RevMan 5.3 for quantitative synthesis of findings from included studies .Results Thirteen retrospective case-control studies including 88 808 patients (42 991 blood transfusion cases , 45 817 non-transfusion cases ) were eligible for inclusion .The pooled analysis revealed statistically significant differences in all the postoperative outcomes :30-day mortality ( OR=2.39 , 95%CI:1.71-3.34 , P〈0.000 01 ) , 1-year mortality ( OR =3.08 , 95% CI: 2.18 -4.35 , P〈0.000 01 ) , 5-year mortality ( OR=1.90 , 95%CI:1.42-2.56 , P〈0.0001 ) , ischemic accident ( OR=2.23 , 95%CI:1.71-2.90 , P〈0.000 01 ) , and infection ( OR=2.18 , 95%CI:1.74-2.75 , P〈0.000 01 ) .Conclusion Perioperative blood transfusion may be strongly related with the risk of postoperative short -and long-term mortality, ischemic events , and infection following cardiac surgery .
出处
《协和医学杂志》
2016年第6期426-431,共6页
Medical Journal of Peking Union Medical College Hospital
关键词
心外科
输血
META分析
cardiac surgery
blood transfusion
Meta-analysis