重组人细胞生成素在胸外科手术患者围术期的作用

Perioperative Application of Recombinant Human Erythropoietin in Thoracic Surgery Patients

目的:观察重组人红细胞生成素(rHuEPO)对胸外科手术患者围手术期的治疗效果。方法:选择胸外科手术患者65例,随机分为2组,实验组35例,对照组30例。实验组术前7d开始皮下注射rHuEPO 10 000IU,隔日1次,至术后3d,一共6次;对照组则不给予rHuEPO。观察术前7d(用rHuEPO前),术前1d、术后1d和术后7d两组患者血红蛋白(Hb)、红细胞(Rbc)和红细胞比积(Hct)水平的变化;比较术后两组患者C反应蛋白(CRP)和降钙素原(PCT)恢复正常的时间,伤口感染率和肺部感染率的差异。结果:术前7d,实验组Hb、Rbc、Hct的水平与对照组相比无明显差异(P>0.05);术前1d,实验组Hb、Rbc、Hct的水平高于对照组(P<0.05);术后1d,实验组Hb、Rbc、Hct的水平与对照组相比无明显差异(P>0.05);术后7d,实验组Hb、Rbc、Hct的水平高于对照组(P<0.05);术后实验组CRP、PCT恢复正常的时间明显少于对照组(P<0.05);术后两组伤口感染率和肺部感染率无明显差异(P>0.05)。结论:胸外科手术患者围手术期应用rHuEPO可有效刺激红细胞动员,并可能促进患者术后组织创伤的修复。

Objective： To investigate the perioperative application of recombinant human erythropoietin （rHuEPO） in thoracic surgery patients. Methods. Sixty-five patients were randomly divided into two groups. The rHuEPO group involved 35 patients and control group involved 30 patients. The 35 patients in experimental group received subcutaneous rHuEPO 10 000 IU on alternate days from 7 days before operation to 3 days after operation. The 30 patients in control group did not received rHuEPO treat- ment. Results： The levels of hemoglobin, cell and hematokrit of patients between the two groups had no significant difference （all P〉0.05）. Compared with control group, 1 day before operation and 7 days after operation, the patients of experimental group had higher levels of hemoglobin, red blood cell and hematokrit （all P〈0. 05）. The recovery time of C-reactive protein and proealcitonin of the patients in rHuEPO group were lower than those in control group （both P〈0.05）, but the rates of wound or pulmonary infection between the two groups had no significant difference （P〉0. 05）. Conclusion： rHuEPO can effectively stimulate red blood cell mobilization in perioperative thoracic surgery patients, and may promote the recovery of tissue trauma after operation.