Awobusuyi Jacob O, Mapayi Francis A, Adedolapo Akeem
Lagos State University College of Medicine Ikeja, Lagos, Nigeria.
Hemodial Int. 2008 Jan;12(1):90-3. doi: 10.1111/j.1542-4758.2008.00247.x.
Anemia is an important complication of chronic renal disease, with a significant impact on the morbidity, quality of life, and mortality in this group of patients. Inadequate erythropoietin production, reduced life span of erythrocytes in uremic serum, bone marrow suppression by uremic toxins, chronic inflammation, and contaminants in the water treatment unit are recognized etiological causes of anemia in chronic kidney disease patients. Little attention has been paid to possible contributions of small but continual loss of blood during vascular access cannulation for hemodialysis in these patients. The aim of this study is to quantify the volume of blood loss during femoral vein cannulation in patients on hemodialysis. The average volume of blood loss during femoral cannulation was evaluated using a simple and inexpensive procedure of deriving volume of blood lost, from the weights of soaked gauze and drape during the access cannulation procedure. The mean blood loss per procedure during femoral cannulation was 36.52 mL+/-2.70 SD, with a range of 6.47 to 100.20 mL. The calculated average weekly loss in patients on thrice-weekly dialysis schedule is 109.56 mL of blood, with a monthly loss of 438.24 mL. Cumulative blood loss during femoral vein cannulation appears to be significant. Its contribution in the sustenance of anemia in hemodialysis patients deserves further evaluation.
贫血是慢性肾病的一种重要并发症，对这类患者的发病率、生活质量和死亡率有重大影响。促红细胞生成素产生不足、尿毒症血清中红细胞寿命缩短、尿毒症毒素对骨髓的抑制、慢性炎症以及水处理单元中的污染物是慢性肾病患者贫血公认的病因。对于这些患者在血液透析进行血管通路插管过程中少量但持续的失血可能产生的影响，人们关注较少。本研究的目的是量化血液透析患者股静脉插管过程中的失血量。通过一种简单且成本低廉的方法来评估股静脉插管过程中的平均失血量，该方法是根据插管过程中浸湿纱布和手术单的重量来推算失血量。股静脉插管每次操作的平均失血量为36.52 mL±2.70标准差，范围为6.47至100.20 mL。按每周进行三次透析的方案计算，患者每周的平均失血量为109.56 mL，每月失血量为438.24 mL。股静脉插管过程中的累积失血量似乎相当可观。其在维持血液透析患者贫血状态中的作用值得进一步评估。
