摘要
心脏疾病患者,特别是体外循环下心脏手术患者常合并贫血。由于心脏代偿能力的下降,患者的贫血风险可能高于心脏功能正常的患者。为降低贫血风险,这些患者常在围术期输注悬浮红细胞;然而输血也增加患者术后并发症发生风险,甚至影响远期预后。因此采用合适的输血策略,以平衡缺血风险和输血风险成为心脏疾病领域重要的研究方向。根据输血策略的不同,目前几个大样本多中心随机对照研究对比了限制性输血和宽松性输血对患者的影响,但仍未得到一致结论。本文回顾了RCT研究中这2种输血策略对患者预后的影响。
Patients withheart disease usually suffer anemia, especially the patients underwent cardiac surgery under cardiopulmonary bypass. On account of the decline of cardiac compensation, they may have a higher risk of anemia than those with normal cardiac function. To reduce the adverse impact induced by anemia, most of them would receive allogenic packed red blood cells in the perioperative period. Unfortunately, blood transfusion may also be associated with the increased risk of morbidities, even with the long-term adverse outcomes. Thus, the optimal blood transfusion strategy is evoked to balance the risk of anemia and transfusion. Several large well-designed multi-center randomized controlled trials (RCT) compared the effects of Restrictive or Liberal blood transfusion on outcomes, but their results are controversial. This review would assess the effects of the two transfusion strategies on the outcomes, based on the RCTs.
作者
陈长伟
杜磊
CHEN Changwei;DU Lei(Department of anesthesidogy,West China hospital,Sichuan University,Chengdu 610041,China.)
出处
《中国输血杂志》
CAS
2018年第8期898-904,共7页
Chinese Journal of Blood Transfusion
基金
国家自然科学基金面上项目(81570374)
关键词
心脏疾病
输血策略
限制性
宽松性
heart disease
blood transfusion strategy
restrictive
liberal