Department of Blood Transfusion, Wuhan Hospital of Traditional Chinese and Western Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Transfusion, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Orthop Surg Res. 2023 Jul 18;18(1):510. doi: 10.1186/s13018-023-03926-y.
Postoperative anemia is a risk factor for adverse surgical outcomes. Our study aimed to assess the role of intravenous iron and erythropoietin therapy for the rapid correction of anemia following orthopedic surgery.
Patients undergoing elective orthopedic surgery were prospectively enrolled and randomly divided into three groups: Control (placebo), Group 1 (IV iron monotherapy), and Group 2 [combined IV iron and recombinant human erythropoietin (rHuEPO) therapy]. Blood tests were performed preoperative (baseline) and on postoperative days (PODs) 1, 3, and 7.
All groups demonstrated significantly lower hemoglobin (Hb) concentrations compared to baseline, with no significant inter-group differences in postoperative Hb concentrations (p > 0.05). Serum erythropoietin, ferritin, and vitamin B levels, and reticulocyte count increased beyond normal ranges in all groups. Significantly lower serum iron levels were observed postoperatively in all groups (p < 0.05). No significant inter-group differences in hepcidin level were observed (p > 0.05).
Postoperative treatment with combined intravenous iron and rHuEPO was ineffective in correcting postoperative anemia among orthopedic surgery patients, besides achieving higher reticulocyte counts in the first week of surgery. No improvement in mobilization of storage iron was achieved with rHuEPO. We further suggest against vitamin B administration during the early postoperative period.
术后贫血是手术不良结局的危险因素。本研究旨在评估静脉铁和促红细胞生成素治疗在骨科手术后迅速纠正贫血的作用。
前瞻性招募择期骨科手术患者，并随机分为三组：对照组（安慰剂）、第 1 组（静脉铁单药治疗）和第 2 组[静脉铁联合重组人促红细胞生成素（rHuEPO）治疗]。术前（基线）和术后第 1、3 和 7 天进行血液检查。
所有组的血红蛋白（Hb）浓度均明显低于基线，术后 Hb 浓度无显著组间差异（p>0.05）。所有组的血清促红细胞生成素、铁蛋白和维生素 B 水平以及网织红细胞计数均升高至正常值以上。所有组术后血清铁水平均显著降低（p<0.05）。各组之间的铁调素水平无显著差异（p>0.05）。
除了在手术后的第一周内获得更高的网织红细胞计数外，骨科手术患者术后联合使用静脉铁和 rHuEPO 治疗对纠正术后贫血无效。rHuEPO 并未改善储存铁的动员。我们进一步建议在术后早期不要给予维生素 B 治疗。
