蔗糖铁联合重组人促红细胞生成素治疗老年股骨粗隆间骨折围术期贫血患者的作用

The efficacy of iron sucrose combined with recombinant human erythropoietin for the treatment of perioperative anemia in elderly patients with intertrochanteric fractures

目的探讨应用蔗糖铁联合重组人促红细胞生成素(EPO)对老年股骨粗隆间骨折围术期贫血恢复及术后功能恢复的影响。方法回顾性对比分析2016年7月至2018年12月于我院行防旋股骨近端髓内钉(PFNA)治疗老年股骨粗隆间骨折治疗患者78例,观察组围术期使用蔗糖铁联合EPO,共40例;对照组围术期未采取其他干预措施。比较两组术后第1天、第3天、第5天、第7天、出院前血红蛋白;术前,术后2周及术后3个月髋关节Harris评分等。结果观察组术后5 d[(98.8±8.6)g/L和(92.2±8.5)g/L,t=3.389,P=0.001]、7 d[(105.4±8.9)g/L和(94.8±8.5)g/L,t=5.370,P=0.000]及出院前[(115.4±8.6)g/L和(100.6±8.2)g/L,t=7.771,P=0.000]血红蛋白高于对照组;观察组术后3个月Harris评分高于对照组[(82.4±3.8)分和(75.8±2.5)分,t=8.933,P=0.000];Pearson相关分析显示,术后第5天,第7天血红蛋白与术后3个月Harris评分呈正相关。出院前Hb对术后3个月Harris评分有影响。结论老年股骨粗隆间骨折围术期联合应用蔗糖铁及EPO能促进患者术后血红蛋白恢复,降低贫血发生率,并加快术后早期功能恢复,提高患者生存质量。

Objective To investigate the effects of iron sucrose combined with recombinant human erythropoietin(EPO)on perioperative anemia and early functional recovery in elderly patients with intertrochanteric fractures.Methods A retrospective comparative analysis was performed on 78 elderly patients who received PFNA treatment for intertrochanteric fractures in our hospital from July 2016 to December 2018.In the observation group,40 cases were treated with iron sucrose combined with erythropoietin during the perioperative period.No perioperative intervention measures were taken for the control group.Hemoglobin(Hb)levels at 1,3,5,7 days and before discharge and Harris scores of hip joints before surgery,2 weeks and 3 months after surgery were compared between the two groups.Results Hb levels were higher in the observation group than in the control group at 5 d[(98.8±8.6 g/L vs.92.2±8.5 g/L,t=3.389,P=0.001)]and 7 d[(105.4±8.9)g/L vs.(94.8±8.5)g/L,t=5.370,P=0.000]after surgery and before discharge[(115.4±8.6)g/L vs.(100.6±8.2)g/L,t=7.771,P=0.000].Harris scores were higher in the observation group than in the control group 3 months after surgery(82.4±3.8 vs.75.8±2.5,t=8.933,P=0.000).Pearson's correlation analysis showed that Hb levels at 5d and 7d after surgery were positively correlated with Harris scores at 3 months after surgery.Hb levels before discharge had an effect on Harris scores at 3 months after surgery.Conclusions The combined administration of iron sucrose and EPO perioperatively can promote postoperative Hb recovery,reduce the incidence of anemia,accelerate early functional recovery and improve the quality of life in elderly patients with intertrochanteric fractures.