促红细胞生成素对改善股骨转子间骨折术后贫血的作用  

Efficacy of recombinant human erythropoietin administration for correction of anemia in patients with intertrochanteric fractures——a randomized controlled trial

作　　者：王宇仁[1] 杨越华[1] 倪斌斌[1] 

机构地区：[1]上海交通大学医学院附属新华医院成人骨科,上海200092

出　　处：《临床骨科杂志》2014年第5期489-492,共4页Journal of Clinical Orthopaedics

基　　金：上海市自然科学基金(编号:08JC145800)

摘　　要：目的探讨促红细胞生成素(rHuEPO)改善股骨转子间骨折术后贫血的临床疗效。方法将100例符合标准的股骨转子间骨折患者随机分为实验组(50例)和对照组(50例)。实验组给予rHuEPO皮下注射治疗,对照组不给予rHuEPO治疗,余治疗相同。比较两组患者术后输血、功能恢复和并发症发生率。结果实验组6例接受输血治疗,对照组14例接受输血治疗,差异有统计学意义(14.5%vs 27.6%,P=0.04);实验组于出院时血红蛋白水平为(108.2±10.5)g/L,对照组为(100.5±9.2)g/L,差异有统计学意义(P=0.01);术后1、3个月实验组FIM评分分别为(85.8±13.4)分和(100.2±15.2)分,显著高于对照组的(70.0±15.2)分和(86.6±20.4)分(P<0.01);并发症:实验组发生9例,对照组发生11例;两组比较差异无统计学意义(P=0.65)。结论 rHuEPO在股骨转子间骨折术后应用是安全的,并可减少输血和促进术后恢复。Objective To determine the clinical Significance of recombinant human erythropoietin （rHuEPO） ap- plied in intertrochanteric fractures. Methods 100 patients were enrolled into the study according to the inclusion and exclusion criteria. They were randomly allocated into the study group （ n = 50） who were administered with rHuEPO sub-cutaneous injection starting on the day of admission, the control group （ n = 50） without rHuEPO or any erythropoietin-like medicine. The same operation and rehabilitation regime were given to two groups. The need for allogenic blood transfusions （ABTs）, functional rehabilitation and complication rate were compared. Results Significant differences were observed in the percentage of patients requiring transfusion [ study group 6（ 14. 5% ） vs control group 14 （27 6% ） P = 0. 04 ] The mean hemoglobin levels at discharge of the study group and the control group was （108.2 ±10. 5） g/L and （100. 5 ±9. 2） g/L, respectively, with a significance （P =0. 01）. FIM scores at the follow-up of one month and three months were higher in patients who received rHuEPO （ 85.8± 13.4, 100. 2 ± 15.2） than those who did not （70. 0 ± 15.2, 86. 6 ± 20.4） （P 〈 0.01 ）. Overall, complications occurred in 9 cases in the study group and 11 cases in the control group, but the difference had no statistical significance （P = 0. 65）. Conclusions rHuEPO can effectively reduce the need for ABTs and accelerate the early functional recovery in patients with intertrochanteric fractures.

关 键 词：股骨转子间骨折 贫血 功能恢复 促红细胞生成素 

分 类 号：R683.42[医药卫生—骨科学] R556[医药卫生—外科学]