术前静脉补铁和促红细胞生成素治疗 4 期肾病患者肿瘤手术前重度贫血：1 例报告。
Preoperative Intravenous Iron and Erythropoietin to Treat Severe Anemia in Patient With Stage 4 Kidney Disease Before Oncologic Surgery: A Case Report.
机构信息
From the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
出版信息
A A Pract. 2020 Jun;14(8):e01234. doi: 10.1213/XAA.0000000000001234.
Abstract
Preoperative treatment of anemia with intravenous iron is inconsistent despite known risks of anemia and allogeneic blood transfusions. Limited research exists on the effectiveness of preoperative intravenous iron for chronic kidney disease (CKD) patients. We discuss a patient with severe anemia from advanced CKD, endometrial cancer, and menometrorrhagia. Her hemoglobin increased more than 2 g/dL after erythropoietin and two 750-mg ferric carboxymaltose infusions 5 weeks before a total abdominal hysterectomy and avoided blood transfusions perioperatively. By raising hemoglobin, preoperative intravenous iron and erythropoietin reduce blood transfusions and consequent risk of future allograft rejection and alloimmunization in potential transplant recipients.
摘要
尽管已知贫血和异体输血的风险，但术前用静脉铁治疗贫血的做法并不一致。对于慢性肾脏病 (CKD) 患者，术前静脉内用铁的效果的相关研究有限。我们讨论了一位患有晚期 CKD、子宫内膜癌和子宫功能性出血的严重贫血患者。在接受全腹部子宫切除术 5 周前，她接受了促红细胞生成素和两次 750mg 羧基麦芽糖铁输注，血红蛋白增加了超过 2g/dL，避免了围手术期输血。通过提高血红蛋白水平，术前静脉内用铁和促红细胞生成素减少了输血，从而降低了潜在移植受者未来同种异体移植排斥和同种免疫的风险。
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