Trzciński Radzisław, Kujawski Ryszard, Mik Michał, Berut Maciej, Dziki Łukasz, Dziki Adam
Department of General and Colorectal Surgery, Medical University of Lodz, Lodz, Poland.
Prz Gastroenterol. 2015;10(1):33-40. doi: 10.5114/pg.2014.47496. Epub 2015 Feb 6.
Surgeons face a special challenge in treating Jehovah's Witnesses who refuse blood transfusion.
To present our surgical experience with this group of patients operated on in our department.
A retrospective study of 16 unselected Jehovah's Witnesses patients was conducted between October 2004 and February 2012. We analysed gender, age, haemogram before and after surgery, types of surgery, postoperative complications and the need for blood transfusion, and/or other drugs stimulating erythrogenesis.
Eighty-one percent of patients were women; the average age of all patients was 57.3 years. Mean haemoglobin level, preoperative, postoperative, and on the day of discharge from hospital, was 12.5 g/dl, 9.7 g/dl, and 9.29 g/dl, respectively. Over the same time period, mean red blood cell count was 4.53 mln/µl, 3.58 mln/µl, and 3.37 mln/µl, respectively. Two out of 16 patients agreed to have blood transfusion. Drugs used for erythropoiesis stimulation included rEPO, ferrum, and folic acid. No surgical death was noted.
We found that abdominal surgery was safe in our small group of Jehovah's Witness patients. However, all Jehovah's Witness patients should be fully informed about the type of procedure and possible consequences of blood transfusion refusal. Two of our patients agreed to blood transfusion in the face of risk of death.
外科医生在治疗拒绝输血的耶和华见证人时面临特殊挑战。
介绍我们科室对这组患者进行手术的经验。
对2004年10月至2012年2月间未经挑选的16例耶和华见证人患者进行回顾性研究。我们分析了性别、年龄、手术前后的血常规、手术类型、术后并发症以及输血需求和/或其他刺激红细胞生成的药物。
81%的患者为女性;所有患者的平均年龄为57.3岁。术前、术后及出院当日的平均血红蛋白水平分别为12.5 g/dl、9.7 g/dl和9.29 g/dl。在同一时期,平均红细胞计数分别为453万/µl、358万/µl和337万/µl。16例患者中有2例同意输血。用于刺激红细胞生成的药物包括重组促红细胞生成素、铁剂和叶酸。未观察到手术死亡病例。
我们发现,在我们这一小群耶和华见证人患者中,腹部手术是安全的。然而,所有耶和华见证人患者都应充分了解手术类型以及拒绝输血可能产生的后果。我们的两名患者在面临死亡风险时同意输血。