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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
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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。

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    2017-07-04 howi

    #Lancet#

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    2018-02-05 智慧医人

    #输血策略#

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    2017-11-06 zchen

    #上消化道#

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    2017-04-18 windight

    #输血#

    0

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    2017-04-18 changhe715

    #消化道#

    0

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