Dudrick S J, O'Donnell J J, Matheny R G, Unkel S P, Raleigh D P
South Med J. 1986 Jun;79(6):669-73. doi: 10.1097/00007611-198606000-00005.
Optimal parenteral nutritional support, provided concomitantly with extraordinarily large replacement doses of intravenous iron dextran can be safe, effective, and life-saving for severely anemic patients who cannot or will not accept erythrocyte transfusion. Five patients who had sustained massive acute blood loss and two who had severe chronic anemia received as much as 140 ml of iron dextran intravenously. The average initial hemoglobin value in the patients with acute blood loss was 4.7 gm/dl (range 2.6 to 8.4 gm/dl), increasing to an average of 9.8 gm/dl (range 7.5 to 12.8) in 23.4 days (range 17 to 30 days), a 166% increase. The average initial hemoglobin value in the patients with chronic anemia was 3.7 gm/dl, increasing to 10.5 gm/dl over an average period of 121 days, a 182% increase. Total abdominal colectomy, pyloroplasty with truncal vagotomy, and highly selective vagotomy were accomplished without complications in four of the patients. There were no adverse reactions to the therapeutic regimen, and all patients were discharged in good condition.
对于那些不能或不愿接受红细胞输血的严重贫血患者，在给予超大剂量静脉注射右旋糖酐铁的同时提供最佳肠外营养支持是安全、有效的，甚至可能挽救生命。五名遭受大量急性失血的患者和两名患有严重慢性贫血的患者静脉注射了多达140毫升的右旋糖酐铁。急性失血患者的平均初始血红蛋白值为4.7克/分升（范围为2.6至8.4克/分升），在23.4天（范围为17至30天）内平均升至9.8克/分升（范围为7.5至12.8），增长了166%。慢性贫血患者的平均初始血红蛋白值为3.7克/分升，在平均121天内升至10.5克/分升，增长了182%。四名患者成功进行了全腹结肠切除术、胃幽门成形术加迷走神经干切断术以及高选择性迷走神经切断术，且无并发症。该治疗方案没有不良反应，所有患者均康复出院。
