协和医学杂志

2016, (06)

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输注血液制品与心脏术后结局相关性的系统分析
Correlation Between Blood Transfusion and Postoperative Outcomes following Cardiac Surgery: A Systematic Review

李晓凤;张超纪;刘剑州;马国涛;刘兴荣;苗齐

摘要(Abstract):

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RevMan 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). ConclusionPerioperative blood transfusion may be strongly related with the risk of postoperative short- and long-term mortality, ischemic events, and infection following cardiac surgery.

关键词(KeyWords): |心外科|输血|Meta分析|
|cardiac surgery|blood transfusion|Meta-analysis|

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作者(Author): 李晓凤;张超纪;刘剑州;马国涛;刘兴荣;苗齐

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