Pharmacy Service, Morales Meseguer General University Hospital, C/ Marqués de los Vélez, s/n, 30008, Murcia, Spain.
World J Surg. 2012 Aug;36(8):1893-7. doi: 10.1007/s00268-012-1589-x.
The goal of the present study was to determine whether the intravenous administration of iron in the postoperative period of colon cancer surgical patients suffices to reduce the number of transfusions necessary.
The study was designed as a retrospective observational study conducted over a three-year period. A paired case-control design was used to analyze the effect of postoperative iron on patients' blood transfusion needs. Two groups were established (the case group, which received postoperative iron and the control group, which did not) and matched for age (± 3 years), gender, type of operation, tumor stage, and surgical approach. Of 342 patients who underwent operation, 104 paired patients were obtained for inclusion in this study (52 in each group). A second analysis was made to assess the effect of intravenous iron on the evolution of hemoglobin between the first postoperative day and hospital discharge in the subgroup of patients with reduction in hemoglobin, in subjects without preoperative or postoperative transfusions. Finally, a total of 71 patients were paired in two groups: 37 and 31 patients in case and control, respectively.
The mean hemoglobin concentration at discharge for the case group was 10 ± 1.1 g/dl, vs. 10.6 ± 1.2 in the controls (P = 0.012). The number of transfusions in the case group was 3 ± 1.6, vs. 3.3 ± 3 in the control group (P = 0.682). Thus, 28.8 % of the patients in the case group received transfusions, versus 30.8 % of those in the control group (P = 0.830). In the second analysis, the decrease in hemoglobin concentration was 0.88 g/dl and 0.82 g/dl in case and control, respectively.
Intravenous iron does not appear to reduce the blood transfusion requirements in the postoperative period of colorectal surgery patients with anemia. We consider that further studies are needed to more clearly define the usefulness of intravenous iron in reducing the transfusion needs in such patients.
本研究的目的是确定结肠癌手术后患者静脉补铁是否足以减少所需的输血次数。
本研究设计为一项为期三年的回顾性观察研究。采用配对病例对照设计分析术后铁剂对患者输血需求的影响。建立两组（接受术后铁剂的病例组和未接受的对照组），并按年龄（± 3 岁）、性别、手术类型、肿瘤分期和手术方式进行匹配。在 342 例接受手术的患者中，获得了 104 对符合条件的患者纳入本研究（每组 52 例）。对血红蛋白降低的患者进行第二次分析，评估静脉铁剂对术后第一天至出院时血红蛋白变化的影响，这些患者术前和术后均未输血。最后，两组共配对 71 例患者：病例组 37 例，对照组 31 例。
病例组出院时血红蛋白浓度平均值为 10 ± 1.1 g/dl，对照组为 10.6 ± 1.2 g/dl（P = 0.012）。病例组输血次数为 3 ± 1.6，对照组为 3.3 ± 3（P = 0.682）。因此，病例组 28.8%的患者输血，对照组为 30.8%（P = 0.830）。在第二次分析中，病例组和对照组的血红蛋白浓度分别下降 0.88 g/dl 和 0.82 g/dl。
静脉铁似乎不能减少贫血的结直肠手术后患者的输血需求。我们认为需要进一步研究以更清楚地确定静脉铁在减少此类患者输血需求方面的作用。
