围术期贫血的风险及输血治疗对预后的影响

发布时间：2018-11-15 20:08

【摘要】：贫血是一个全球问题,约25%的人存在贫血。而目前虽无明确的证据证明贫血直接造成病死率的增加,但临床多项回顾性研究显示贫血与病死率增加有一定的关系。至于贫血通过何种机制导致病死率的增加,目前还没有确切的说法。但多项研究和分析结果显示贫血导致组织供氧不足,组织缺氧,器官衰竭甚至死亡。输注红细胞、注射促红素及增加血红蛋白氧载体常用以改善贫血,但并无有力证据证明其却有降低病死率的影响。造成组织缺氧的血红蛋白值的检测方法多种,但临床实用性不强。组织缺氧的生物标记物方面的研究可能为围术期贫血预后提供参考。输血仍是治疗围术期贫血的主要方法,但其并发症和对预后的影响不容忽视。手术患者的输血治疗主要发生在手术室内,麻醉科医师应当是输血相关并发症和适应症方面的专家。同时麻醉医师应该跟进目前血液管理新进展,积极主动降低因输血所造成的不良后果。
[Abstract]:Anemia is a global problem, with about 25% of people suffering from anaemia. Although there is no clear evidence that anemia directly leads to an increase in mortality, a number of clinical retrospective studies have shown that anemia is associated with an increase in mortality. The mechanism by which anaemia leads to an increase in mortality is not immediately known. But a number of studies and analyses show that anemia leads to tissue hypoxia, organ failure and even death. Red blood cell transfusion, injection of propofol and increased hemoglobin oxygen carrier are commonly used to improve anemia, but there is no strong evidence that it has the effect of reducing mortality. There are many methods to detect the hemoglobin value, but the clinical practicability is not strong. The study of tissue anoxia biomarkers may provide a reference for the prognosis of perioperative anemia. Blood transfusion is still the main method to treat perioperative anemia, but its complications and influence on prognosis can not be ignored. The blood transfusion treatment of surgical patients mainly occurs in the operating room, and the anesthesiologist should be an expert in transfusion related complications and indications. At the same time, anesthesiologists should follow the current progress in blood management and actively reduce the adverse consequences of blood transfusion.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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