回收式自体输血在泌尿外科手术中有效性与安全性的Meta分析

doi:10.3969/j.issn.1671-2587.2025.05.006

临床输血与检验 ›› 2025, Vol. 27 ›› Issue (5): 621-628.DOI: 10.3969/j.issn.1671-2587.2025.05.006

回收式自体输血在泌尿外科手术中有效性与安全性的Meta分析

王翔, 孙俊波, 吴庆四, 陈礼文

安徽医科大学第二附属医院输血科,安徽合肥 230601

收稿日期:2025-09-01 修回日期:2025-09-11 出版日期:2025-10-20 发布日期:2025-10-11
通讯作者: 孙俊波,主要从事输血医学研究,（E-mail）sunjunbo@fy.ahmu.edu.cn。
作者简介:王翔,主要从事输血医学研究,（E-mail）ahmuamy@126.com。

Efficacy and Safety of Intraoperative Cell Salvage in Urological Surgery: A Meta-analysis

WANG Xiang, SUN Junbo, WU Qingsi, CHEN Liwen

Department of Blood Transfusion, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601

Received:2025-09-01 Revised:2025-09-11 Online:2025-10-20 Published:2025-10-11

摘要/Abstract

摘要： 目的系统评价回收式自体输血（IOCS）在泌尿外科开放手术中减少异体输血需求的有效性及对术后并发症与肿瘤复发率的影响。方法计算机检索中英文数据库（PubMed、EMbase、Cochrane Library、Web of Science、CNKI、万方等）,搜集IOCS应用于泌尿外科手术的队列研究及随机对照试验,检索时限为建库至2025年3月。由2名研究者独立筛选文献、提取数据并评估偏倚风险后,采用RevMan 5.3和Stata 17.0软件进行Meta分析。结果共纳入16项队列研究（2 551例患者）。Meta分析结果显示,与未使用IOCS组相比,IOCS显著降低异体输血率[OR=0.37,95%CI（0.14~0.98）,P=0.04],但与预存式自体输血组差异无统计学意义[OR=0.66,95%CI（0.35~1.24））,P=0.20]。两组术后总并发症发生率无显著差异[OR=0.98,95%CI（0.57~1.68）,P=0.93]。IOCS组肿瘤复发率显著低于对照组[OR=0.49,95%CI（0.33~0.71）,P=0.000 2],前列腺切除术亚组效应更显著[OR=0.37,95%CI（0.23~0.61）,P<0.000 1]。结论回收式自体输血可有效降低泌尿外科手术的异体输血需求,且未增加术后并发症风险。受限于纳入研究的异质性,IOCS的长期肿瘤学安全性仍需高质量的前瞻性研究支持。

关键词: 回收式自体输血, 泌尿外科手术, 异体输血, 肿瘤复发, Meta分析

Abstract: Objective To systematically evaluate the effectiveness of intraoperative cell salvage (IOCS) in reducing allogeneic blood transfusion (ABT) requirements and its potential impact on postoperative complications and tumor recurrence in urological open surgery. Methods Databases including PubMed, EMbase, Cochrane Library, Web of Science, CNKI, and WanFang were searched from inception to March 2025 for cohort studies and randomized controlled trials on IOCS application in urological surgery. Two researchers independently screened literature, extracted data, and assessed bias risk. Meta-analyses were conducted using RevMan 5.3 and Stata 17.0. Results Sixteen cohort studies (2 551 patients) were included. Meta-analysis showed that IOCS significantly reduced ABT rates compared to the non-IOCS group [OR=0.37, 95%CI (0.14~0.98), P=0.04], but no significant difference was observed when compared to preoperative autologous donation [OR=0.66, 95%CI (0.35~1.24), P=0.20]. No significant difference was found in overall postoperative complications [OR=0.98, 95%CI (0.57~1.68), P=0.93]. The IOCS group exhibited a significantly lower tumor recurrence rate [OR=0.49, 95%CI (0.33~0.71), P=0.000 2], with a more pronounced effect in the prostatectomy subgroup [OR=0.37, 95%CI (0.23~0.61), P<0.000 1]. Conclusion IOCS effectively reduces ABT requirements in urological surgery without increasing short-term complications. Due to the heterogeneity of the included studies, the long-term oncological safety of IOCS still requires high-quality prospective research support.

Key words: Intraoperative cell salvage, Urological surgery, Allogeneic blood transfusion, Tumor recurrence, Meta-analysis

中图分类号:

R457

王翔, 孙俊波, 吴庆四, 陈礼文. 回收式自体输血在泌尿外科手术中有效性与安全性的Meta分析[J]. 临床输血与检验, 2025, 27(5): 621-628.

WANG Xiang, SUN Junbo, WU Qingsi, CHEN Liwen. Efficacy and Safety of Intraoperative Cell Salvage in Urological Surgery: A Meta-analysis[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2025, 27(5): 621-628.

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回收式自体输血在泌尿外科手术中有效性与安全性的Meta分析

Efficacy and Safety of Intraoperative Cell Salvage in Urological Surgery: A Meta-analysis

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