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恶性肿瘤患者术中自体血回输的临床实践指南

朱长太邹锋文爱清戎瑞明夏荣钱宝华马昕李玲李志强宛新建陈世耀潘健张奕任翔韩坤

中国输血杂志2025，Vol.38Issue(2)：149-167,19.

中国输血杂志2025，Vol.38Issue(2)：149-167,19.DOI:10.13303/j.cjbt.issn.1004-549x.2025.02.001

恶性肿瘤患者术中自体血回输的临床实践指南

Clinical practice guidelines for intraoperative cell salvage in patients with malignant tumors

朱长太 ¹邹锋 ²文爱清 ³戎瑞明 ⁴夏荣 ⁵钱宝华 ⁶马昕 ⁷李玲 ⁸李志强 ⁹宛新建 ¹⁰陈世耀 ¹¹潘健 ¹²张奕 ¹³任翔 ¹³韩坤¹⁴

作者信息

1. 上海交通大学医学院附属上海第六人民医院输血科,上海 200233||上海市医学会输血专科分会,上海 200040
2. 上海交通大学医学院附属上海第六人民医院麻醉科,上海 200233
3. 陆军军医大学大坪医院输血医学科创伤与化学中毒全国重点实验室,重庆 400042
4. 复旦大学附属中山医院输血医学科,上海 200032||上海市医学会输血专科分会,上海 200040
5. 复旦大学附属华山医院输血医学科,上海 200040||上海市医学会输血专科分会,上海 200040
6. 海军军医大学第一附属医院输血医学科,上海 200433||上海市医学会输血专科分会,上海 200040
7. 上海交通大学医学院附属上海第六人民医院骨科,上海 200233
8. 西南交通大学附属医院/成都市第三人民医院输血科,四川成都 610031
9. 上海交通大学医学院附属上海第六人民医院输血科,上海 200233||中国输血协会临床输血管理专委会,北京 100088
10. 上海交通大学医学院附属上海第六人民医院消化内科,上海 200233
11. 复旦大学循证医学中心,上海 200032
12. 中国科学技术第一附属医院《临床输血与检验》编辑部,安徽合肥 230001
13. 上海交通大学医学院附属上海第六人民医院输血科,上海 200233
14. 上海交通大学医学院附属上海第六人民医院肿瘤科,上海 200233
折叠

摘要

Abstract

Intraoperative cell salvage(IOCS)has been widely applied as an important blood conservation measure in surgical operations.However,there is currently a lack of clinical practice guidelines for the implementation of IOCS in pa-tients with malignant tumors.This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence.Data were derived from databases such as PubMed,Embase,the Cochrane Library and Wanfang.The guideline development team formulated recommendations based on the quality of evidence,balance of benefits and harms,patient preferences,and health economic assessments.This study constructed seven major clinical questions.The main conclusions of this guideline are as follows:1)Compared with no peri-operative allogeneic blood transfusion(NPABT),perioperative allogeneic blood transfusion(PABT)leads to a more unfa-vorable prognosis in cancer patients(Recommended);2)Compared with the transfusion of allogeneic blood or no transfu-sion,IOCS does not lead to a more unfavorable prognosis in cancer patients(Recommended);3)The implementation of IOCS in cancer patients is economically feasible(Recommended);4)Leukocyte depletion filters(LDF)should be used when implementing IOCS in cancer patients(Strongly Recommended);5)Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients(Recommended);6)A careful assessment of the condi-tion of cancer patients(meeting indications and excluding contraindications)should be conducted before implementing IOCS(Strongly Recommended);7)Informed consent from cancer patients should be obtained when implementing IOCS,with a thorough pre-assessment of the patient's condition and the likelihood of blood loss,adherence to standardized internally audited management procedures,meeting corresponding conditions,and obtaining corresponding qualifications(Recommended).In brief,current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation,and LDF or irradiation should be used during the implementation process.

关键词

术中自体血回输(IOCS)/自体输血/恶性肿瘤/手术/指南

Key words

intraoperative cell salvage(IOCS)/autologous transfusion/malignant tumor/surgery/guidelines

分类

医药卫生

引用本文复制引用

朱长太,邹锋,文爱清,戎瑞明,夏荣,钱宝华,马昕,李玲,李志强,宛新建,陈世耀,潘健,张奕,任翔,韩坤..恶性肿瘤患者术中自体血回输的临床实践指南[J].中国输血杂志,2025,38(2):149-167,19.

基金项目

国家自然基金资助项目(82270789) （82270789）

上海市申康医院发展中心临床创新项目(SHDC12015910) （SHDC12015910）

上海市第六人民医院特色学科项目(院学科 2020014) （院学科 2020014）

中国输血杂志

ISSN：1004-549X

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