胃癌根治术患者术前静脉注射蔗糖铁改善贫血的研究  

Peroperative clinical study of intravenous iron sucrose in patients with radical gastric cancer

作　　者：朱雯雯[1] 李莺[1] 周小玉[1] ZHU Wenwen;LI Ying;ZHOU Xiaoyu(Department of Blood Thansfusion,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院输血科,江苏南京210029

出　　处：《中国肿瘤外科杂志》2023年第6期572-575,共4页Chinese Journal of Surgical Oncology

摘　　要：目的 探讨静脉注射蔗糖铁对胃癌根治术患者围术期输血和临床情况的影响。方法 选取2022年1月—2023年6月在南京医科大学第一附属医院进行胃癌根治术治疗的贫血患者186例,根据其贫血状况分为术前重度贫血组42例(术前HB<80 g/L),术前中度贫血组64例(术前HB为80~<100 g/L),以及术前轻度贫血组80例[术前HB为100~120 g/L(女性),100~130 g/L(男性)];重度贫血组中使用蔗糖铁组(A组)22例,未使用蔗糖铁组(B组)20例。中度贫血组中A组26例,B组38例。根据术后血红蛋白水平,将80例术前轻度贫血患者进行分组:术后继发中度贫血组47例,术后未继发中度贫血组33例。比较各组的临床输血情况。结果 重度贫血组中,B组住院期间红细胞输注量大于A组,差异有统计学意义(P=0.002),在术前中度贫血组中,A组与B组住院期间红细胞输注量差异无统计学意义(P=0.495)。术前重度贫血A、B两组间患者术后24 h、7d、30 d的血红蛋白水平和住院时间差异无统计学意义(P>0.05)。对于术前HB>100 g/L的患者,术前注射与不注射蔗糖铁患者的术后继发贫血的发生率无明显差异(P=0.655)。结论 术前静脉注射蔗糖铁能显著减少重度贫血患者围术期红细胞输注量,而不影响其术后24 h、7d、30 d的血红蛋白水平,且不延长住院时间。Objective To investigate the effect of intravenous iron sucrose on perioperative transfusion and clinical condition in patients with radical gastric cancer.Methods A total of 186 anemia patients were treated in the First Affiliated Hospital of Nanjing Medical University from January 2022 to June 2023.According to their anemia status,they were divided into preoperative severe anemia group,preoperative moderate anemia group,postoperative anemia group and postoperative no anemia group.The two preoperative anemia groups were divided into A using iron sucrose and B without using iron sucrose according to intravenous iron sucrose injection status in patients.Results The difference between the total amount of perioperative red blood cell transfusion was significant in group A and Group B in the preoperative severe anemia group(P=0.002),and it was not significant in the preoperative moderate anemia group(P=0.495).There’s no difference between the postoperative hemoglobin of 24 hours,7days and 30days and hospital days in group A and Group B in the preoperative severe anemia group(P>0.05).Postoperative anemia and no anemia were not associated with iron sucrose infusion(P=0.655).Conclusions Intravenous iron sucrose can significantly reduce the perioperative red blood cell transfusion in patients with severe anemia,and don’t reduce the postoperative hemoglobin of 24 hours,7days and 30days,don’t extend the hospital days.

关 键 词：蔗糖铁 胃癌根治术 贫血 

分 类 号：R735.2[医药卫生—肿瘤]