重组人促红细胞生成素及硫酸亚铁在Rh阴性骨盆骨折患者手术中的临床应用价值

Application of recombination human erythropoietin and iron sulfate in pelvic fracture surgery in Rh negative patients

目的探讨Rh阴性骨盆骨折患者围手术期应用重组人促红细胞生成素(recombination human erythropoietin,rhEPO)及硫酸亚铁对血红蛋白及血小板计数水平的影响。方法 Rh阴性骨盆骨折患者20例,依据是否应用rhEPO及硫酸亚铁分为观察组和对照组各10例。观察组于术前7、3 d及术后第2天分别皮下注射rhEPO 100 u/kg并口服硫酸亚铁颗粒,50 mg/次,3次/d,至术后第14天;对照组不应用rhEPO及硫酸亚铁,比较2组用药前、术前1 d及术后第2、7、14天血红蛋白及血小板计数。结果观察组术前1 d及术后第2、7天血红蛋白水平[(135.25±31.25)、(98.35±27.23),(115.45±29.75)g/L]高于对照组[(124.30±30.14),(82.38±20.75),(90.24±21.35)g/L](P均<0.05);用药前及术后第14天血红蛋白水平[(125.26±26.12)、(121.74±30.25)g/L]与对照组[(125.12±31.38),(118.35±25.45)g/L]比较差异无统计学意义(P均>0.05);观察组用药前、术前1 d及术后第2、7、14天血小板计数[(162.27±49.23)×10~9/L,(165.35±56.14)×10~9/L、(140.75±51.23)×10~9/L、(155.47±48.75)×10~9/L、(215.75±71.25)×10~9/L]与对照组[(161.85±49.87)×10~9/L、(160.82±52.45)×10~9/L、(146.27±50.28)×10~9/L、(159.78±49.87)×10~9/L、(220.89±72.56)×10~9/L]比较差异均无统计学意义(P>0.05)。结论 Rh阴性骨盆骨折患者围术期应用rhEPO及硫酸亚铁可减轻术后贫血,并加快血红蛋白的恢复。

Objective To investigate the effect of perioperative application of recombination human erythropoietin(rhEPO) and iron sulfate on hemoglobin and blood platelet count in Rh negative patients with pelvis fracture.Methods Twenty Rh negative patients with pelvis fracture were divided into observation group and control group,with 10 patients in each group.Observation group received subcutaneous injection of rhEPO 100 u/kg on preoperative day 7 and 3 and on postoperative day 2,and oral adminstration of 50 mg iron sulfate particles,three times a day till the 14 day after operation.Control group received no rhEPO or iron sulfate.The levels of hemoglobin and blood platelet count were compared before treatment,on preoperative day 1,and on postoperative day 2,7 and 14.Results The hemoglobin levels were significantly higher on preoperative day 1,and on postoperative day 2 and 7 in observation group((135.25±31.25),(98.35±27.23),(115.45±29.75) g/L) than those in control group((124.30±30.14),(82.38±20.75),(90.24±21.35) g/L)(P<0.05),and there were no significant differences before treatment and on 14 day after operation between observation((125.26±26.12),(121.74±30.25) g/L) and control group((125.12±31.38),(118.35±25.45) g/L)(P>0.05).There were no significant differences in blood platelet count levels before treatment,on preoperative day 1,and on postoperative day 2,7 and 14 between observation group((162.27±49.23)× 10~9/L,(165.35±56.14)×10~9/L,(140.75±51.23)×10~9/L,(155.47±48.75)×10~9/L,(215.75±71.25)×10~9/L) and control group((161.85±49.87)×10~9/L,(160.82±52.45)×10~9/L,(146.27±50.28)×10~9/L,(159.78±49.87) ×10~9/L,(220.89±72.56)×10~9/L)(P>0.05).Conclusion The perioperative application of rhEPO and iron sulfate can relieve anemia after operation and improve the recovery of hemoglobin level in Rh negative patients with pelvis fracture.