围手术期血红蛋白水平与患者预后及非心脏手术后心肌损伤发生率的研究进展

Research progress of perioperative hemoglobin level in patient prognosis and myocardial injury after noncardiac surgery(MINS)

非心脏手术后心肌损伤(myocardial injury after noncardiac surgery,MINS)是非心脏手术术后的常见并发症,并与术后死亡率密切相关。大多数MINS患者无明显临床症状,易漏诊或误诊从而影响治疗,但MINS的结局与患者是否出现明显的临床症状或体征无关。因此,早期识别MINS的高危因素具有重要意义。大约40%的手术患者合并术前贫血,即使是轻度贫血也与各种术后并发症及非心脏手术后死亡率相关。术前贫血与MINS独立相关,MINS可能是术前贫血与术后30 d死亡率的桥梁因素。术后血红蛋白水平与心肌损伤之间也有很强的相关性。本文就围手术期血红蛋白水平与MINS关系的相关研究进行文献总结,为临床决策及后续研究提供参考。

Myocardial injury after noncardiac surgery(MINS)is a common complication after noncardiac surgery which is associated with postoperative mortality.The symptoms of most patients are silent,being easy to miss or misdiagnose and affecting treatment.However,there is an equally poor prognosis regardless of whether they are symptomatic.Therefore,it is of interest to identify the high risk factors of MINS.About 40%of surgical patients have preoperative anemia,even mild anemia is associated with various postoperative complications and mortality after non-cardiac surgery.Preoperative anemia is also independently related to MINS,which may be a bridge factor between preoperative anemia and postoperative 30-day mortality.There is a correlation between postoperative hemoglobin level and myocardial injury as well.This review will summarize the literature on the relationship between perioperative hemoglobin level and MINS,which might provide reference for clinical decision-making and future research.