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妇产科中静脉铁补充剂使用情况的评估

Evaluation of the Use of Intravenous Iron Supplements in an Obstetrics and Gynecology Department.

作者信息

Michon Nicole, Bernier Pascaline, Ferreira Ema

机构信息

CHU Ste-Justine, Montreal, Québec, Canada.

Université de Montréal, Montreal, Québec, Canada.

出版信息

J Pharm Technol. 2014 Jun;30(3):97-101. doi: 10.1177/8755122514528808. Epub 2014 Mar 24.

Abstract

The use of intravenous (IV) iron sucrose was approved for the obstetric and gynecologic (OBGYN) population at our mother-child teaching hospital in 2006 for intolerance or nonresponse to oral iron supplements, contraindication to intramuscular (IM) iron, and rapid increase of the hemoglobin desired in iron-deficient patients. () To describe the indications and doses of IV iron sucrose used in OBGYN, () to assess monitoring, and () to describe the adverse effect profile. A retrospective study of patients admitted to the OBGYN wards with at least one prescription of IV iron from January 1, 2006, to March 31, 2010, was conducted. A standardized data collection sheet was used to record data. A total of 164 prescriptions of IV iron were reviewed in 128 women. The indications for IV iron were anemia before delivery (n = 76), intolerance or no response to oral iron (n = 61), or intolerance or contraindication to IM iron (n = 27). Fourteen doses (9%) were appropriate, and the others were too low. Prior to prescription, ferritin or serum iron levels were assessed in 31% of women and hemoglobin electrophoresis in nearly all of Black or Asian women. One-week follow-up hemoglobin levels were measured after 66 prescriptions (40.2%). Adverse effects, mostly pain at the injection site, were reported in 18 (11%) occasions. IV iron is prescribed in OBGYN patients to obtain a rapid hemoglobin increase or when oral iron is not tolerated or inefficacious. The dose prescribed is generally too low, baseline essential testing often omitted, and appropriate follow-up monitoring incomplete. IV iron is well tolerated.

摘要

2006年,我院母婴教学医院批准静脉注射蔗糖铁用于妇产科人群,适用于对口服铁剂不耐受或无反应、肌内注射铁剂有禁忌证以及缺铁患者所需血红蛋白快速增加的情况。()描述妇产科使用静脉注射蔗糖铁的适应证和剂量,()评估监测情况,()描述不良反应情况。对2006年1月1日至2010年3月31日入住妇产科病房且至少有一次静脉注射铁剂处方的患者进行回顾性研究。使用标准化数据收集表记录数据。共审查了128名女性的164份静脉注射铁剂处方。静脉注射铁剂的适应证为产前贫血(n = 76)、对口服铁剂不耐受或无反应(n = 61)或对肌内注射铁剂不耐受或有禁忌证(n = 27)。14剂(9%)剂量合适,其他剂量过低。在开处方前,31%的女性进行了铁蛋白或血清铁水平评估,几乎所有黑人或亚洲女性进行了血红蛋白电泳。66份处方(40.2%)后测量了1周随访血红蛋白水平。18次(11%)报告了不良反应,主要是注射部位疼痛。妇产科患者开具静脉注射铁剂是为了使血红蛋白快速升高,或在口服铁剂不耐受或无效时使用。所开剂量通常过低,基线必要检查常被省略,适当的随访监测不完整。静脉注射铁剂耐受性良好。

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本文引用的文献

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Anemia in pregnancy.妊娠期贫血
Clin Lab Med. 2013 Jun;33(2):281-91. doi: 10.1016/j.cll.2013.03.016. Epub 2013 Apr 19.
5
Diagnosis and treatment of iron-deficiency anaemia during pregnancy and postpartum.妊娠期和产后缺铁性贫血的诊断与治疗。
Arch Gynecol Obstet. 2010 Nov;282(5):577-80. doi: 10.1007/s00404-010-1532-z. Epub 2010 Jun 25.
8
Compliance to iron supplementation during pregnancy.孕期铁补充剂的依从性。
J Obstet Gynaecol. 2009 Aug;29(6):487-92. doi: 10.1080/01443610902984961.

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