全膝关节置换术后自体血回输有效性的Meta分析

目的进一步了解21世纪以来对自体血回输技术应用于膝关节置换术后的有效性评价。方法检索PubMed、EMBASE、ProQuestCentral和WebofScience自2000年1月1日至2016年10月31日的自体血回输应用于膝关节置换术后的随机前瞻对照性研究，采用Jadad评分标准进行评价，使用RevMan5.1.7软件，对接受异体红细胞患者的输血率和输注容量进行分析。结果共纳入13篇文献，包括2126例患者。Meta分析表明，与对照组相比，自体血回输组的输血率降低（RR=0.68，95%CI：0.51~0.92，P=0.01），但是对输注容量的影响差异无统计学意义（加权均数差：-0.10，95%CI:-0.79~0.58，P=0.77）。相关文献可能存在一定发表性偏倚。结论自体血回输技术可降低输血率，但不能减少异体红细胞输注容量，因此仍无法判定此项技术是否有效。需要将来有高质量临床研究发表后进行深入评价。

Efficacy of blood salvage in total knee arthroplasty: a meta-analysis

Objective To assess the efficacy of blood salvage for reducing red blood cell (RBC) transfusion in arthroplasty. Methods PubMed, EMBASE, ProQuest Central and Web of Science from January2000 to October 2016 were searched for randomized clinical trials (RCTs) of blood salvage in arthroplasty. Software RevMan5.1.7 was used for meta-analysis. Results Thirteen RCTs involving 2126 cases were included for meta-analysis. The results showed that, compared to the control group blood salvage reduced the transfusion rate (RR: 0.68, 95% CI:0.51- 0.92, P=0.01), but did not decrease the transfusion volume (W MD:-0.10, 95% CI: -0.79 to 0.58, P=0.77). Conclusion Blood salvage may reduce the allogeneic RBC transfusion rate, but may not decrease the transfusion volume. High quality studies are needed in the future for definite conclusion.