临床实践中的患者血液管理：一种多模式围手术期方法。
完整摘要 · 中文译文
患者血液管理（PBM）是一种以循证医学为基础、多模式结合的方法，旨在提高患者安全性、减少可避免的同种异体输血，并节约有限的血液资源。其核心组成部分之一是术前贫血的早期检测与治疗，术前贫血是围手术期死亡、输血率增加及住院时间延长的独立危险因素。在柏林夏里特医学院，标准化的PBM路径将贫血筛查整合入存在相关出血和输血风险患者的术前评估中。贫血患者接受进一步诊断评估，随后进行针对病因的治疗，特别是静脉补铁、促红细胞生成素或两者联合使用。治疗成功与否通过术前重复检测血红蛋白来评估。其他PBM措施包括术中自体血回输的针对性使用、个体出血风险的标准化评估，以及抗凝和抗血小板治疗的基于风险的围手术期管理。这些措施共同构成了一种结构化的跨学科方法，旨在减少围手术期失血和输血需求，同时提高患者安全性。
完整摘要 · 英文原文
Patient Blood Management (PBM) is an evidence-based, multimodal approach to improve patient safety, reduce avoidable allogeneic blood transfusions, and preserve limited blood resources. A central component is the early detection and treatment of preoperative anemia, an independent risk factor for perioperative mortality, increased transfusion rates, and prolonged hospital stays.At Charité - University Medicine Berlin, a standardized PBM pathway integrates anemia screening into the preoperative assessment of patients with a relevant risk of bleeding and transfusion. Patients with anemia undergo further diagnostic evaluation followed by cause-specific treatment, particularly with intravenous iron, erythropoietin, or a combination of both. Treatment success is assessed by repeat hemoglobin measurement prior to surgery.Additional PBM measures include the targeted use of intraoperative cell salvage, standardized assessment of individual bleeding risk, and risk-adapted perioperative management of anticoagulant and antiplatelet therapy. Together, these measures provide a structured, interdisciplinary approach to reducing perioperative blood loss and transfusion requirements while improving patient safety.