重组人促红细胞生成素应用于关节置换手术围手术期改善贫血的研究进展

Progress in the Study of Recombinant Human Erythropoietin Used for Perioperative Improvement of Anemia in Joint Replacement Surgery

关节置换术是非常成功的手术方式,但该手术方式创伤大,围手术期贫血是非常常见的围手术期并发症。现在针对围手术期贫血情况的治疗有异体输血,自体血预存及自体血回输3种主要方法,而异体输血现在是最常用的方法。但异体输血会导致异体输血血源不足以及发生细菌、病毒感染、发热等并发症。并且随着人口老龄化的到来,围手术期需要输血治疗的关节置换患者将明显增加,血源不足的情况将愈发严峻。关节置换手术围手术期使用重组人促红细胞生成素能减轻贫血的严重程度,降低患者的输血率,然而其有效性、使用剂量与方法、不良反应及成本效益仍需进一步研究。本文将对关节置换手术围手术期使用重组人促红细胞生成素改善贫血的研究进展作一综述。

Joint replacement is a very successful surgical method, but the surgical method is very traumatic, and perioperative anemia is a very common perioperative complication. There are three main methods for perioperative anemia: autologous blood transfusion, autologous blood prestorage and autologous blood transfusion, and allogeneic blood transfusion is now the most commonly used method. However, allogeneic blood transfusion can lead to insufficient allogeneic blood source and bacterial, viral infection, fever and other complications. Moreover, with the arrival of the aging pop-ulation, the number of joint replacement patients requiring blood transfusion treatment in the perioperative period will significantly increase, and the situation of insufficient blood source will become more severe. The perioperative use of ecombinant human erythropoietin can reduce the severity of anemia and reduce the blood transfusion rate in patients, however, its efficacy, dose and method used, adverse effects and cost-effectiveness still need further research. This review will re-view the progress of the use of recombinant human erythropoietin to improve anemia in the peri-operative period of joint replacement surgery.