Lancet

订阅

MedSci主页 / 所有栏目 / Lancet

Lancet：成人急性上消化道出血输血策略选择

2017-04-16 zhangfan MedSci原创

成人急性上消化道出血限制性输血预后
关注

限制性输血对于成人急性上消化道出血的治疗和预后的收益更大

红细胞（RBC）输血是急性上消化道出血的主要治疗手段，但最佳的输血方式尚不清楚。

研究人员对MEDLINE， EMBASE， CENTRAL， CINAHL等临床试验以及血库数据进行荟萃分析，比较限制性和自由性红细胞输血策略对急性上消化道出血的影响。研究主要结果包括死亡率，再出血发生率，缺血性事件以及平均RBC输血量。研究还比较了，如肝硬化患者、非静脉曲张性上消化道出血患者和缺血性心脏病患者等患者，亚组之间的治疗效果差异。

研究包括四个已发表和一个未发表的随机对照试验，共有1965参与者。限制输血组输血的RBC量低于自由输血组(平均差异 -1.73单位，95% CI-2.36至-1.11，p<0.0001)；限制性输血与全因死亡率和整体再出血降低的相关(相对风险 0.65，95% CI 0.44-0.97；相对风险 0.58，95% CI 0.40-0.84)；缺血性事件的风险两组无显着差异；亚组间差异无统计学意义。

研究表明，限制性输血对于成人急性上消化道出血的治疗和预后的收益更大。

原文出处：


本文系梅斯医学（MedSci）原创编译整理，转载需授权！

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1828878, encodeId=fb2618288e8f6, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 04 04:38:00 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946104, encodeId=49961946104b5, content=<a href='/topic/show?id=b63a93836ac' target=_blank style='color:#2F92EE;'>#输血策略#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93836, encryptionId=b63a93836ac, topicName=输血策略)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon Feb 05 00:38:00 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723050, encodeId=bb891e2305045, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Mon Nov 06 07:38:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259667, encodeId=7914125966e8e, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464531, encodeId=751c146453108, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=)]
    2017-07-04 howi

    #Lancet#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1828878, encodeId=fb2618288e8f6, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 04 04:38:00 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946104, encodeId=49961946104b5, content=<a href='/topic/show?id=b63a93836ac' target=_blank style='color:#2F92EE;'>#输血策略#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93836, encryptionId=b63a93836ac, topicName=输血策略)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon Feb 05 00:38:00 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723050, encodeId=bb891e2305045, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Mon Nov 06 07:38:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259667, encodeId=7914125966e8e, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464531, encodeId=751c146453108, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=)]
    2018-02-05 智慧医人

    #输血策略#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1828878, encodeId=fb2618288e8f6, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 04 04:38:00 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946104, encodeId=49961946104b5, content=<a href='/topic/show?id=b63a93836ac' target=_blank style='color:#2F92EE;'>#输血策略#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93836, encryptionId=b63a93836ac, topicName=输血策略)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon Feb 05 00:38:00 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723050, encodeId=bb891e2305045, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Mon Nov 06 07:38:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259667, encodeId=7914125966e8e, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464531, encodeId=751c146453108, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=)]
    2017-11-06 zchen

    #上消化道#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1828878, encodeId=fb2618288e8f6, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 04 04:38:00 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946104, encodeId=49961946104b5, content=<a href='/topic/show?id=b63a93836ac' target=_blank style='color:#2F92EE;'>#输血策略#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93836, encryptionId=b63a93836ac, topicName=输血策略)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon Feb 05 00:38:00 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723050, encodeId=bb891e2305045, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Mon Nov 06 07:38:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259667, encodeId=7914125966e8e, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464531, encodeId=751c146453108, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=)]
    2017-04-18 windight

    #输血#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1828878, encodeId=fb2618288e8f6, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 04 04:38:00 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946104, encodeId=49961946104b5, content=<a href='/topic/show?id=b63a93836ac' target=_blank style='color:#2F92EE;'>#输血策略#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93836, encryptionId=b63a93836ac, topicName=输血策略)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon Feb 05 00:38:00 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723050, encodeId=bb891e2305045, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Mon Nov 06 07:38:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259667, encodeId=7914125966e8e, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464531, encodeId=751c146453108, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Tue Apr 18 00:38:00 CST 2017, time=2017-04-18, status=1, ipAttribution=)]
    2017-04-18 changhe715

    #消化道#

    0