Br J Haematol:血液肿瘤患者红细胞输血策略 限制还是随意?

2017-07-17 梁舒瑶 吴星 环球医学

血液肿瘤患者接受许多红细胞(RBC)输血,然而缺乏基于证据的指南。2017年7月,发表在《Br J Haematol》的一项系统评价和荟萃分析旨在量化限制性和随意性RBC输血策略对血液肿瘤患者临床结局和血液使用的影响。 对PubMed、EMBASE(ExcerptaMedica Database)、Web of Science、Cochrane、CINAHL (Cumulative Index

血液肿瘤患者接受许多红细胞(RBC)输血,然而缺乏基于证据的指南。2017年7月,发表在《Br J Haematol》的一项系统评价和荟萃分析旨在量化限制性和随意性RBC输血策略对血液肿瘤患者临床结局和血液使用的影响。

对PubMed、EMBASE(ExcerptaMedica Database)、Web of Science、Cochrane、CINAHL (Cumulative Index to Nursing and Allied Health Literature)和Academic Search Premier数据库进行文献检索,截至日期为2016年8月11日,无语言和出版年份限制。比较血液肿瘤患者不同RBC输血策略的随机对照试验和观察性研究符合纳入标准。根据Cochrane协作工具和Newcastle-Ottawa量表,评价风险偏倚。

排除重复之后,确定1142个出版物。最终,纳入15项研究,报告2636例患者。支持限制性策略的合并相对死亡风险为0.68[95%置信区间(CI)0.46~1.01]。限制性策略组每个治疗周期每位输注患者平均RBC的使用降低1.40个单位(95% CI 0.70~2.09)。安全性结局没有差异。

现有的证据表明,限制性策略对血液肿瘤患者的临床结局没有负面影响,而是降低了RBC的使用和相关成本。

原始出处:

Hoeks MPA, Kranenburg FJ, et al. Impact of red blood cell transfusion strategies in haemato-oncological patients: a systematic review and meta-analysis. Br J Haematol. 2017 Jul;178(1):137-151. doi: 10.1111/bjh.14641.

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    2017-10-20 gujh
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    2018-01-03 changfy
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    2017-07-19 windight
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    2017-07-19 fengyi812
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