Luo Chentao, Shi Yunqing, Lin Yi, Ma Runhua, Xia Qi, Ding Wenjun
Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
J Int Med Res. 2020 Feb;48(2):300060520902912. doi: 10.1177/0300060520902912.
To evaluate the efficacy of intravenous iron sucrose (IS) in the perioperative period of a second thoracotomy after open-heart surgery.
This study enrolled patients that underwent a second thoracotomy after previous open-heart surgery. Propensity-score matching was used to match patients that received oral iron therapy with those that received IS after admission. The baseline demographic and clinical characteristics, perioperative data and adverse outcomes were compared between these two matched groups.
The study enrolled 447 patients: of these, 148 received oral iron therapy and effective dietary guidance; and 299 patients received 300 mg IS per week. After matching the propensity scores, there were no significant differences between the two groups in terms of age, sex, smoking history, incidence of major cardiac adverse events, Euro-score, time between the two thoracotomies, application of recombinant erythropoietin, haemoglobin (Hb) on admission and red blood cell (RBC) count on admission. The differences between the two groups after propensity-score matching in terms of the amount of RBC input and Hb after the operation were significant.
The administration of IS might be useful for improving postoperative Hb levels and reducing intraoperative RBC input in patients undergoing a second thoracotomy.
评估静脉注射蔗糖铁(IS)在心脏直视手术后二次开胸手术围手术期的疗效。
本研究纳入了曾接受过心脏直视手术且需进行二次开胸手术的患者。采用倾向得分匹配法,将入院后接受口服铁剂治疗的患者与接受IS治疗的患者进行匹配。比较这两个匹配组之间的基线人口统计学和临床特征、围手术期数据及不良结局。
本研究共纳入447例患者,其中148例接受口服铁剂治疗并给予有效的饮食指导,299例患者每周接受300mg IS治疗。倾向得分匹配后,两组在年龄、性别、吸烟史、主要心脏不良事件发生率、欧洲心脏手术风险评估系统(Euro-score)评分、两次开胸手术间隔时间、重组促红细胞生成素的应用、入院时血红蛋白(Hb)水平及入院时红细胞(RBC)计数方面均无显著差异。倾向得分匹配后,两组在术后RBC输入量及Hb水平方面存在显著差异。
对于接受二次开胸手术的患者,给予IS可能有助于提高术后Hb水平并减少术中RBC输入量。