全髋关节置换术后使用自体血回输引流装置有效性及安全性的Meta分析  

The efficacy and safety of postoperative retransfusion drain following total hip arthroplasty：a Metaanalysis

作　　者：谢锦伟[1] 徐彬[1] 康鹏德[1] 周宗科[1] 沈彬[1] 杨静[1] 裴福兴[1] 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中华外科杂志》2016年第2期108-113,共6页Chinese Journal of Surgery

基　　金：卫生部2013年度卫生行业科研专项资助项目（201302007）

摘　　要：目的探讨全髋关节置换术后使用自体血回输引流装置的有效性及安全性。方法计算机检索PubMed、EMBase、Cochrane Library及中国生物医学文献数据库、中国知网、维普网论文检测系统、万方数据库，收集2015年1月之前发表的关于全髋关节置换术后使用自体血回输引流装置的随机对照试验（RCT）研究。由两名研究者根据纳入和排除标准独立筛选文献、提取资料及评价方法学质量后，采用RevMan5．2软件进行Meta分析。结果最终纳入9项RCT文献，共1824例患者，其中回输组913例，对照组911例。Meta分析结果显示，与普通引流相比，应用自体血回输引流装置可以降低术后异体输血率（RR=0．61，95％CI=0．47—0．79），但与未使用引流相比，优势并不明显（RR=1．07，95％CI=0．67～1．71）。回输组术后血红蛋白水平较高（MD=0．14，95％CI=0．01—0．27，P=0．04）。回输组输血指数、住院时间、发热反应及切口相关并发症的发生率与对照组相比，差异均无统计学意义（P〉0．05）。结论自体血回输引流装置可有效安全地降低全髋关节置换术后异体输血率，但与未使用引流相比，这种优势并不明显。Objective To investigate the effectiveness and safety of post-operative retransfusion drain（ PRD ） after total hip arthroplasty. Methods A systematic literature review based on PubMed, EMBase, the Coehrane Library, China Biology Medicine disc, CNKI, VIP and WanFang Database in any language regarding PRD following total hip arthroplasty was performed. The data was evaluated using modified Jadad score and then analyzed using RevMan 5.2. Results Nine randomized controlled trials totaling 1 824 patients,913 patients in PRD group and 911 in control group,were eligible for data extraction and Meta-analysis. The results indicated that the use of PRD could reduce the requirement of allogeneie blood transfusion when compared with ordinary vacuum drainage （ RR = 0. 61,95% CI = 0. 47 - 0. 79 ）, but the benefit was not found when compared with no drainage group（ RR = 1.07,95% CI = 0. 67 - 1.71 ）. And the postoperative hemoglobin level was higher in PRD group （ AID = 0. 14,95 % CI = 0.01 - 0. 27, P = 0. 04 ）. No significant difference was identified regarding transfusion index, length of hospital stay, the incidence of febrile reaction and wound-related complications. Conclusions PRD in reducing requirement of blood transfusion following THA is effective and safe when compared with ordinary vacuum drainage, but the benefit is not found when compared with no drainage. And more robust evidence is needed to confirm this result.

关 键 词：输血 自体 引流术 关节成形术 置换 髋 META分析 

分 类 号：R687.4[医药卫生—骨科学]