促红细胞生成素在胸主动脉夹层动脉瘤腔内隔绝术中的应用

Application of recombinant human erythropoietin in endovascular graft exclusion for thoracic aortic dissection

目的 :探讨促红细胞生成素在 Stanford B型胸主动脉夹层动脉瘤 (TAD)腔内隔绝术中应用的临床意义和安全性。方法 :2 0例 Stanford B型 TAD患者随机分成 2组 ,给药组 (10例 )术前 3d开始使用重组人促红细胞生成素 (rh EPO)1万 U/ d,皮下给药 ,连续应用 10 d;对照组 (10例 )不给予 rh EPO,其他处理同给药组。用药前 ,术后第 1、3、7、14天观察患者红细胞及其相关指标的变化。结果 :两组患者手术后血红蛋白、红细胞比容均较手术前明显下降 ,分别于术后第 3天和第 1天降至最低值 ,但给药组较对照组回升加快 ,至手术后第 14天时 2项指标均显著高于对照组 ,并恢复至术前水平 ;而两组患者血小板计数 (仅手术后第 3天均较术前明显降低 )及血压术后虽有下降趋势 ,但无统计学差异 ,两组间也无显著性差异。用药期间未发现明显的与药物相关的不良反应。 结论 :术前应用 rh EPO进行人红细胞动员 。

Objective:To evaluate the clinical significance and safety of recombinant human erythropoietin (rhEPO) in endovascular graft exclusion(EVGE) for thoracic aortic dissection(TAD). Methods: Twenty patients underwent EVGE for Stanford B type of TAD were randomly divided into 2 groups in a prospective controlled study. The experimental group(10 patients) received rhEPO(1×10 4 U/d×10 d,sc),while the control group was treated whithout rhEPO. The change of hemoglobin(Hb),hematocrit(HCT),platelet(Plt) count and blood pressure were measured prior to operation,and 1,3,7,14 d postoperation. Results: There were significant difference between 2 groups in Hb and HCT, and no significant difference in Plt count and blood pressure. No side effect was found. Conclusion: It is effective and safe to use rhEPO to relieve blood loss and anemia before EVGE.