优化围术期血液管理  

To Optimize Perioperative Patient Blood Management

作　　者：魏新广 管玉龙[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管疾病国家重点实验室体外循环科,北京100037

出　　处：《中国胸心血管外科临床杂志》2016年第4期390-394,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81170233);教育部留学回国人员科研启动基金(2013-LH 01)~~

摘　　要：血液来源的难题以及血液传播性疾病的危险使得限制性输血策略得到推广和认可,但是最新的临床试验性研究显示心血管患者限制性输血阈值可能导致死亡率增加,因此优化围术期血液管理应制定更为"个性化"的输血策略而非单纯追求不输血。目前的临床证据并不支持优先输注储存期短的红细胞。新近批准使用的病原体灭活技术及药物研究将为输血安全提供基础,提高输血安全和改善临床预后。The limitation of resource of blood and risk of transfusion-transmitted infections contribute to development and generalization of restrictive transfusion strategy.However,advanced evidences of clinical trials indicated a restrictive transfusion threshold after cardiac surgery was not superior to a liberal threshold with respect to morbidity or health care costs.It is time to optimize patient blood management but not free-transfusion and increase of risk of patients.The duration of red-cell storage was not associated with significant differences in the mortality and morbidity of patients.Three new pathogen-reduction technologies and pharmaceutical intervenes may provide safe of transfusion and improvement of outcomes.

关 键 词：输血 安全 阈值 感染 

分 类 号：R457.1[医药卫生—治疗学] R619[医药卫生—临床医学]