创伤患者血小板红细胞输注比例对死亡影响的META分析  

META-analysis of Platelets to Red Blood Cell Ratios and Mortality in Massive Blood Transfusions for Trauma

作　　者：刘勇 叶华[2] 田金飞[1] 李翠玲[1] 罗金海[1] 周昭雄[1] 曾潍贤[3] 

机构地区：[1]南方医科大学深圳医院重症医学科,518101 [2]中山大学孙逸仙纪念医院重症医学科 [3]香港大学深圳医院重症医学科

出　　处：《岭南急诊医学杂志》2016年第4期359-362,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:对创伤患者血小板与红细胞比例对死亡率的影响进行META分析,确定创伤患者血小板的最佳比例。方法:检索1998年1月-2015年6月PUBMED,Cochrane Library,RCT注册网站关于创伤患者血小板与红细胞比例的临床效果进行对比分析的期刊文献,观察对象≥16周岁。涉及遗传性凝血因子缺陷或其他血液病问题的文章被排除。采用STATA12.0分析软件进行统计学分析。结果:3篇RCT论文纳入研究,856例病例。实施高血小板红细胞输血策略的患者为430例。高血小板红细胞输注比例对24 h和28 d死亡率无影响(24h RR 1.00,[95%CI,0.48 to 2.07),28d(RR 1.45,[95%CI,0.67 to 3.10)。结论 :高血小板红细胞输注增加24h止血率,但对24h和28d死亡率较常规输血策略无显著改变。Objective ： To investigate whether high platelets ：red blood cell（RBC） ratios during massive transfusion for trauma decrease mortality. Methods ：A systemic review of the published literature for massive blood transfusions in trauma was performed. Patients were categorised into groups based on plasma ：RBC transfusion ratios.Studies were included regardless of type, patient age, sample size or duration of patient follow-up. Results ： RCT studies reporting outcomes for 856 patients were included in this meta-analysis. Three studies were from civilian environments and one from a military setting. Ratio cut-offs at 1 ：1 were the most commonly reported. No significant differences in mortality were detected at 24 hours（RR 1.00, [95% CI, 0.48 to 2.07） or at 28 days（RR 1.45, [95%CI, 0.67 to 3.10）. Conclusions ：No additional survivalbenefits of high platelets ：RBC resuscitation ratioswere identified although with more patients achieved hemostasis and fewer patients died of exsanguination.

关 键 词：创伤 血小板与红细胞比例 META分析 

分 类 号：R641[医药卫生—外科学]