rh-EPO在储存式自体输血患者红细胞动员中的应用观察

Influence of recombinant human erythropoietin on red blood cell mobilization in patients with preoperative autologous blood transfusion

目的:观察重组人促红细胞生成素(rh-EPO)在储存式自体输血患者红细胞动员中应用价值。方法:以香河县人民医院行储存式自体输血的82例患者为研究对象,按入院顺序分为2组,奇数入对照组,偶数入rh-EPO组,每组41例。2组患者分别于术前7d和3d采血400 ml,于术中或术后回输给患者,同时于采血前1周补充铁剂至最末一次采血后数周或数月。rh-EPO组于术前10 d至术后第7天注射rh-EPO 150 U·kg^(-1)·d^(-1),对照组不应用rh-EPO。观察2组患者术前术后RBC、Hb和Hct的变化以及不良反应发生情况。结果:①2组术前1h、术后第1和第5天RBC、Hb及Hct明显降低,与第1次采血前比较,差异有统计学意义(P<0.05)。rh-EPO组与对照组比较,术后第1、5天RBC、Hb及Hct明显升高,差异有统计学意义(P<0.05);②在自体血回输过程2组患者生命体征平稳、没有出现寒战、发热、过敏等输血不良反应,均顺利完成手术。rh-EPO组患者未发生血黏度增高、血栓等并发症。结论:rh-EPO应用于储存式自体输血患者红细胞动员,可有效改善患者术中及术后的贫血状况。

Objective：To observe the influence of recombinant human erythropoietin（rh-EPO） on red blood cell mobilization in the patients with preoperative autologous blood transfusion.Method：Eighty-two patients with preoperative autologous blood transfusion were chosen as the research object in our hospital between March 2012 and December 2014,According to admission order,odd number was divided into control group and even number into rh-EPO group,and 41 cases were in each group.400 ml of blood were collected at 7 d and 3 d before operation in two groups,and transfused to the patients in operation or the end of the surgery,at the same time the iron agents were complemented at 1 week before blood collecting or weeks or months after blood collecting,150 U kg^（-1） ·d^（-1） of rh-EPO were injected at 10 day before operation to 7 day after operation in rh-EPO group,and rhEPO were not injected in control group,The changes in RBC,Hb,Hct and the adverse reactions before and after operation were observed.Result：①Compared with the first blood collecting,RBC,Hb and Hct at the first postoperative day and fifth day decreased significantly（P〈0.05）.Compared with control group,RBC,Hb and Hct increased significantly at the first and fifth postoperative day（P〈0.05） in rh-EPO group.②The vital signs were stable,and no adverse reactions such as chills,fever and allergies occurred.All surgeries were successfully completed in two groups.The complications did not occur in rh-EPO group.Conclusion：Rh-EPO would be a safe and effective drug in preoperative autologous blood transfusion with red blood cell mobilization,which could effectively improve the condition of intraoperative and postoperative patients with anemia.