促红细胞生成素对髋膝关节置换手术出血的影响

Effect of erythropoietin on hemorrhage of hip replacement surgery

目的 探讨促红细胞生成素对髋关节置换手术出血的影响。方法 选取2014年6月～2016年10月于中国人民解放军第404医院择期行髋关节置换手术患者48例,根据条件相似程度分为试验组和对照组,每组24例,对促红细胞生成素在髋关节置换手术中的应用效果进行了探讨。试验组术前3、5及7 d皮下注射促红细胞生成素,给药剂量为250 U/（kg·次）。对照组经皮下注射等量0.9%氯化钠注射液,其它的处理同试验组。对比分析2组的术前情况、术前1 d和术后3、7及14 d Hb水平、血压（舒张压和收缩压）变化。结果 术前患者的体质量、血红蛋白（Hb）和年龄比较差异无统计学意义。术后3、7 d试验组和对照组术后Hb水平比较,差异有统计学意义（P〈0.05）,术后14 d试验组Hb基本恢复正常,而对照组Hb水平仍然显著低于术前对照组,差异有统计学意义（P〈0.05）。而2组患者舒张压、收缩压差异无统计学意义。结论 髋关节置换手术患者术前经促红细胞生成素动员,可减轻患者术中及术后出血量,且不良反应不明显。

Objective To investigate the effect of erythropoietin on hemorrhage in hip replacement surgery .Methods 48 cases undergoing elective hip replacement surgery in our hospital From June 2014 to October 2016 were selected and devided into control group and experimental group according to the conditional similarity, 24 cases in each group, then the application of erythropoietin in hip replacement surgery was explored.For the experimental group, erythropoietin was injected subcutaneously at three, five and seven days before operation, the dose was 250 U/（kg＆#183; times）.The control group received 0.9%sodium chloride injection of the same volume of saline, and the other treatments were the same as in the experimental group.Preoperative situation, hemoglobin （Hb） levels, blood pressure （diastolic pressure and systolic blood pressure） at one day before surgey and three, seven and 14 days after surgey were compared and analyzed.Results There were no significant difference in body weight, hemoglobin （Hb）, and age between the two groups before operation.The levels of Hb in the experimental group and the control group at 3 and 7 days after operation were compared, the difference was statistically significant （P〈0.05）, 14 days after the surgey, Hb returned to normal in the experimental group, while the Hb level in the control group was still significantly lower than that in the control group before surgey, the difference was statistically significant （P〈0.05）.There was no significant difference in diastolic blood pressure and systolic blood pressure between the two groups.Conclusion Preoperative erythropoietin mobilization in patients with hip replacement surgery can reduce the amount of bleeding during and after operation , and the adverse reactions are not obvious.