首页|心脏外科手术患者围手术期血液管理研究进展

心脏外科手术患者围手术期血液管理研究进展

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输血在心脏手术中难以避免且已被证实对患者总体预后产生不利影响,但患者血液管理(PBM)作为一种基于循证医学的以患者为中心的系统化方案,能够减少不必要的血制品暴露,改善患者预后.文章综述了心脏外科患者围手术期PBM的研究进展,包括术前、术中和术后的不同阶段,旨在为临床医师提供参考.术前阶段重点关注高危出血风险患者的评估以及贫血管理;术中PBM策略的优化涵盖了微创技术、逆行自体血预充、自体血回输、凝血因子浓缩物、抗纤溶剂及粘弹性凝血试验的应用;术后则采取限制性输血策略.
Research progress on perioperative blood management for patients undergoing cardiac surgery
Transfusion in cardiac surgery is hard to avoid and its negative effect on patient outcomes has been proved.Notably,patient blood management(PBM),as an evidence-based,patient-centered,systematic approach,can reduce unnecessary exposure to blood products and improve patient prognosis.This review summarizes the research progress on perioperative blood management dur-ing cardiac surgery,covering the preoperative,intraoperative,and postoperative phases,in order to provide guidance for clinical practitioners.The preoperative phase focuses on the assessment of high-risk bleeding patients and anemia management.Optimization of intraoperative blood management strategies encompasses using minimally invasive techniques,retrograde autologous priming,autologous blood reinfusion,concentrated clotting factors,antifibrinolytics,and viscoelastic coagulation tests.Furthermore,a restrictive transfusion strategy is adopted after surgery.

Cardiac surgeryPerioperativeBlood management

黄培菊、梁杰贤、王晟

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广东省心血管病研究所,广东省人民医院,广东省医学科学院,广州 510080

首都医科大学附属北京安贞医院麻醉科,北京 100029

心脏外科 围手术期 血液管理

2024

国际麻醉学与复苏杂志
中华医学会,徐州医学院

国际麻醉学与复苏杂志

CSTPCD
影响因子:0.909
ISSN:1673-4378
年,卷(期):2024.45(2)
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