| 重组人促红细胞生成素对降低老年股骨粗隆间骨折围手术期输血的病例对照研究 |
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Received:November 13, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 解冰 |
XIE Bing |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 田竞 |
TIAN Jing |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
Tjing@medmail.com.cn |
| 杨超 |
YANG Chao |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 周大鹏 |
ZHOU Da-peng |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 项良碧 |
XIANG Liang-bi |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 期刊信息：《中国骨伤》2015年28卷，第7期，第633-637页 |
| DOI：10.3969/j.issn.1003-0034.2015.07.012 |
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目的:评价术前应用重组人促红细胞生成素(recombinant human erythropoietin,rHuEPO)对降低老年股骨粗隆间骨折择期手术患者围手术期输血的作用。
方法:回顾性分析自2011年1月至2013年12月收治的老年股骨粗隆间骨折患者442例,根据纳入及排除标准,最终入选119例。其中治疗组52例,男12例,女40例,平均年龄(71.4±12.8)岁,术前接受rHuEPO 10 000 U (隔日1次)加右旋糖酐铁200 mg (每日3次);对照组67例,男16例,女51例,平均年龄(70.9±16.2)岁,术前仅接受右旋糖酐铁 200 mg (每日3次).所有患者采用PFNA-Ⅱ(辛迪思公司)或Intertan(施乐辉公司)在闭合复位下固定骨折,观察两组患者围手术期输血率、平均输血量、术后并发症、住院时间及30 d内死亡率。
结果:119例中71例围手术期接受了至少1 U(200 ml)异体血输入。治疗组围手术期输血率48.1%,低于对照组的68.7%(χ2=4.77,P<0.05);治疗组平均输血量(1.8±0.4) U/pte,低于对照组的(3.6±1.1) U/pte(t=2.244,P<0.05).治疗组术后1周及30 d血红蛋白水平高于对照组,且治疗组术后30 d较入院时血红蛋白水平高。两组术后血栓事件、术后感染发生率及住院时间比较差异无统计学意义。
结论:对于择期手术的老年股骨粗隆间骨折患者,术前应用rHuEPO可降低围手术期输血率及平均输血量,但其长期安全性仍有待评价。 |
| [关键词]:重组人促红细胞生成素 输血 老年人 髋骨折 |
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| Case-control study on the efficacy of preoperative recombinant human erythropoietin administration for reducing transfusion requirements in elderly patients undergoing elective surgery for femoral intertrochanteric fractures |
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Abstract:
Objective: To evaluate preoperative application of recombinant human erythropoietin(rHuEPO) in reducing transfusion requirements in elderly patients undergoing elective surgery for femoral intertrochanteric fractures.
Methods: From January 2011 to December 2013,442 cases of elderly patients with femoral intertrochanteric fracture were retrospectively reviewed. According to inclusion and exclusion criteria,119 cases were eventually included and divided into the treatment group and the control group. There were 12 males and 40 females,with a mean age(71.4±12.8) years old,and the patients received preoperative administration of rHuEPO 10 000 U qod combined with iron dextran 200 mg(3 times each day). While 16 males and 51 females in control group,with a mean age(70.9±16.2) years old,and the patients only received preoperative administration of iron dextran 200 mg(3 times each day). All the patients received closed reduction and PFNA-Ⅱ or Internal fixation surgeries. The perioperative blood transfusion rate,average amount of blood transfusion,postoperative complications,the length of hospital stay and mortality within 30 days were compared between the two groups.
Results: There were no statistical differences between two groups in the baseline indexes (P >0.05). Overall,71 of 119 patients (59.7%) received at least one unit allogeneic blood transfusion (ABT). However,there were significant differences in perioperative ABT rates(48.1% vs 68.7%,χ2=4.77,P<0.05) and the average amount of blood transfusion between treatment group and control group,which were(1.8±0.4) U/pte vs (3.6±1.1) U/pte(t=2.244,P<0.05). Postoperative hemoglobin (Hb) on postoperative days 7 and 30 was higher in treatment group than that in control group. In addition,in treatment group,Hb levels were higher on postoperative day 30 than those on admission,which were (128.2±20.6) g/L vs (118.2±18.9) g/L(t=2.133,P<0.05). There were no statistical differences in postoperative complications,the length of hospital stay and mortality within 30 days.
Conclusion: For elderly patients with femoral intertrochanteric fractures undergoing elective surgery,preoperative application of rHuEPO can significantly reduce perioperative transfusion requirements,and is likely to reduce ABT-related infection,but its long-term safety remains to be evaluated. |
| KEYWORDS:Recombinant human erythropoietin Blood transfusion Aged Hip fractures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 解冰,田竞,杨超,周大鹏,项良碧.重组人促红细胞生成素对降低老年股骨粗隆间骨折围手术期输血的病例对照研究[J].中国骨伤,2015,28(7):633~637 |
| 英文格式: | XIE Bing,TIAN Jing,YANG Chao,ZHOU Da-peng,XIANG Liang-bi.Case-control study on the efficacy of preoperative recombinant human erythropoietin administration for reducing transfusion requirements in elderly patients undergoing elective surgery for femoral intertrochanteric fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(7):633~637 |
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