重组人促红细胞生成素短期快速应用对同期双侧全膝关节置换术围手术期输血的影响

Effiect of preoperative recombinant human erythropoietin short term and rapid administration on reducing transfusion requirements in patients undergoing simultaneous bilateral total knee arthroplasty

关键词:  重组人促红细胞生成素  同期双侧全膝关节置换  输血

Key words:  recombinant human erythropoietin  simultaneous bilateral total knee arthroplasty  blood transfusion

摘要:

目的评价重组人促红细胞生成素（recombinant human erythropoietin，rHuEPO）短期快速应用对同期双侧全膝关节置换术围手术期输血的作用及安全性。方法回顾性分析2013年1月至2015年11月大连医科大学附属第二医院关节外科收治的行同期双侧全膝关节置换的患者72例，根据资料完整程度最终选入63例。所有患者入院后均给予多糖铁复合物胶囊补充铁剂。治疗组30例患者于术前3～5 d使用rHuEPO（10000 IU皮下注射，隔日1次，共7次）；对照组33例不给予其他治疗。观察两组患者围手术期输血情况、不良反应、术前及术后2、4、7天血红蛋白（Hb）、红细胞压积（HCT）变化。结果治疗组围手术期输血率（23.33%）低于对照组（48.48%），输血量（2.29±0.78）U小于对照组（3.81±0.94）U，差异均有统计学意义，P<0.05。治疗组术后2、4、7天的Hb及HCT均高于对照组，差异有统计学意义，P<0.05。两组术后不良反应及并发症发生情况比较，差异无统计学意义，P>0.05。结论同期双侧全膝关节置换术患者在围手术期短期快速应用rHuEPO可显著降低输血率及平均输血量，且临床应用较为安全，可考虑临床广泛推广。

Abstract:

Objective To evaluate the effect and safety of recombinant human erythropoietin (rHuEPO) in short term rapid administration in patients undergoing simultaneous bilateral total knee arthroplasty. Methods Seventy-two cases of patients were retrospective analyzed who underwent simultaneous bilateral total knee arthroplasty from January 2013 to November 2015 in the Second Hospital of Dalian Medical University. According to data integrity, 63 cases were eventually included and divided into treatment group and control group. All patients were administrated polysaccharide-iron complex capsules after hospitalized. Patient in the treatment group (n=30) were preoperative used rHuEPO 10000 IU qod（a total of 7 times）3 to 5 days and patients in the control group (n=33) with no additional treatment. The perioperative transfusion, adverse reaction, changes of HCT and Hb before and 2 day, 4 day, 7 day after operation were compared between the two groups. Results There were significant differences in allogeneic blood transfusion rate (23.33% vs. 48.48%, P<0.05) and the blood transfusion amount ［(2.29±0.78) U vs. (3.81±0.94) U, P<0.05)］ between treatment and control group. Hb and HCT of patients in treatment group on 2d, 4d and 7d after operation were higher than those in control group. There were no significant differences in complication and adverse reaction. Conclusion For patients undergoing simultaneous bilateral total knee arthroplasty, short term and rapid perioperative rHuEPO treatment would reduce allogeneic blood transfusion rate and amount safely.