全膝关节置换术围术期应用重组人促红细胞生成素的安全性分析

Safety Analysis of Perioperative Application of Recombinant Human Erythropoietin in Total Knee Replacement

目的:探讨全膝关节置换术患者围手术期应用重组人促红细胞生成素(EPO)的安全性。方法:选取2020年5月-2022年6月张家界市人民医院骨一科收治的初次行全膝关节置换术患者52例为观察对象,根据随机数字表法分为观察组与对照组,各26例。对照组给予常规治疗,观察组在常规治疗基础上给予重组人EPO治疗。比较两组患者心肌酶(磷酸肌酸激酶、磷酸肌酸激酶同工酶、乳酸脱氢酶),空腹血糖,术后1、7、30 d的血压差异。结果:术后1、7 d,观察组肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶水平低于对照组,差异有统计学意义(P<0.05);术后30 d,两组患者肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶水平比较,差异无统计学意义(P>0.05)。术后1、7、30 d,两组患者收缩压、舒张压、空腹血糖比较,差异无统计学意义(P>0.05)。结论:全膝关节置换患者围手术期短期应用重组人EPO不会增加心、肝功能损害及血糖、血压升高风险。

Objective:To investigate the safety of perioperative application of recombinant human erythropoietin(EPO)in patients with total knee replacement.Methods:A total of fifty-two patients who underwent total knee replacement for the first time admitted to the Department of Orthopaedics I,Zhangjiajie People's Hospital from May 2020 to June 2022 were selected as the observation objects.According to the method of random number table,they were divided into observation group and control group,with twenty-six cases in each group.The control group was given conventional treatment,and the observation group was given recombinant human EPO treatment on the basis of conventional treatment.The differences of myocardial enzymes(phosphocreatine kinase,phosphocreatine kinase isoenzyme,lactate dehydrogenase),fasting blood glucose,and blood pressure 1,7 and 30 days after surgery were compared between the two groups.Results:On day 1 and 7 after surgery,the levels of creatine kinase,creatine kinase isoenzyme and lactate dehydrogenase in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).30 days after surgery,there was no statistical significance in the levels of creatine kinase,creatine kinase isoenzyme and lactate dehydrogenase between 2 groups(P>0.05).There was no significant difference in systolic blood pressure,diastolic blood pressure and fasting blood glucose between 2 groups at 1,7 and 30 days after surgery(P>0.05).Conclusion:Short-term use of recombinant human EPO during perioperative period of total knee replacement does not increase the risk of cardiac and liver function impairment,blood glucose and blood pressure increase.