初次单侧全膝关节置换静脉或口服应用蔗糖铁围置换期贫血及输血率的比较

目的对比研究静脉、口服应用蔗糖铁对初次单侧人工全膝关节置换术患者围手术期出血量及输血率的影响。 方法前瞻性收集2017年7月至2018年6月在新疆维吾尔自治区人民医院行初次单侧人工膝关节置换术的120例患者，采用系统随机抽样法随机分为3组：静脉用药组40例，口服用药组40例，空白对照组40例，静脉用药及口服用药组铁剂用药总量均为300 mg/d，术前应用3 d，术后应用4 d。比较3组红细胞比容下降最大值、血红蛋白下降最大值、围手术期总失血量、输血率。 结果静脉用药组术后输血率、Hb平均下降最大值、平均总失血量、Hct平均下降最大值明显低于口服用药组和空白组，差异均有统计学意义（P<0.01），而口服用药组与空白组的输血率、围手术期总失血量、HGB下降最大值、Hct下降最大值无明显差异（P>0.05）。 结论静脉应用蔗糖铁可明显减少初次单侧人工全膝关节置换术患者术后失血量，并降低术后输血率，效果要优于口服应用蔗糖铁和空白对照组。口服应用蔗糖铁和空白对照组患者术后失血量及输血率无明显差异。

Initial unilateral total knee arthroplasty with intravenous or oral administration of sucrose: Comparison of hemorrhage and transfusion rate in peri-replacement period

ObjectiveTo investigate the effect of intravenous and oral application of iron sucrose on perioperative blood loss and transfusion rate in patients undergoing primary unilateral total knee arthroplasty. Methods120 patients who underwent primary unilateral knee arthroplasty in Xinjiang Uygur Autonomous Region People's Hospital from July 2017 to June 2018 were randomly divided into three groups, 40 patients in intravenous iron sucrose group, 40 patients in oral iron sucrose group and 40 patients in blank control group. The total amount of iron sucrose used in the first two groups was 300 mg/d, 3 days before operation and 4 days after operation. The maximum decrease of RBC specific volume, hemoglobin, total perioperative blood loss and transfusion rate were compared among the three groups. ResultThe blood transfusion rate, the average maximum decrease of HGB, the average total blood loss and the average decrease of Hct in intravenous iron sucrose group were significantly lower than those in oral iron sucrose group and blank group (P<0.01). There was no significant difference between oral iron sucrose group and blank group in blood transfusion rate, perioperative total blood loss, the maximum decrease of HGB and the maximum decrease of Hct. There was no statistical significance (P>0.05). ConclusionIntravenous application of iron sucrose can significantly reduce the amount of blood loss after knee arthroplasty, and can significantly reduce the rate of blood transfusion, the effect is better than the other two groups. There was no significant difference in blood loss and transfusion rate between oral iron sucrose group and blank group.