Benites Bruno Deltreggia, Magnus Mariana Munari, Costa Lorena, Brunetta Denise Menezes, Rodriges Roseny Dos Reis, Alves Susankerle de Oliveira Costa, De Santis Gil Cunha, Rizzo Silvia Renata Cornélio Parolin, Rabello Guilherme, Junior Dante Mario Langhi
Centro de Hematologia e Hemoterapia da Universidade Estadual de Campinas (Hemocentro UNICAMP), Campinas, SP, Brazil.
Universidade de Pernambuco (UPE), Recife, PE, Brazil.
Hematol Transfus Cell Ther. 2024 Apr;46 Suppl 1(Suppl 1):S72-S76. doi: 10.1016/j.htct.2024.02.014. Epub 2024 Mar 19.
Postoperative anemia is a complex clinical issue that requires attention due to its ramifications on the patient's recovery and prognosis. Originating from multiple determinants, such as intraoperative blood loss, hemolysis, nutritional deficiencies, systemic inflammation and impact on the bone marrow, postoperative anemia has varied and often challenging presentations. Patients undergoing major surgical procedures, in particular, are susceptible to developing anemia due to the considerable associated blood loss. Accurate diagnosis plays a crucial role in the approach, requiring meticulous hematological analysis, including hemoglobin, hematocrit and reticulocyte count, as well as an in-depth investigation of the underlying causes. An additional challenge arises in the form of the excessive practice of phlebotomy during hospitalization for clinical monitoring. Although it is essential to assess the progression of anemia, frequent removal of blood may contribute to iatrogenic anemia, further delaying recovery and possibly increasing susceptibility to infection.
术后贫血是一个复杂的临床问题，因其对患者恢复和预后的影响而需要引起关注。术后贫血源于多种因素，如术中失血、溶血、营养缺乏、全身炎症以及对骨髓的影响，其表现多样且往往具有挑战性。特别是接受大型外科手术的患者，由于术中大量失血，容易发生贫血。准确诊断在处理过程中起着关键作用，这需要细致的血液学分析，包括血红蛋白、血细胞比容和网织红细胞计数，以及对潜在病因的深入调查。住院期间因临床监测而过度进行静脉放血的做法带来了另一个挑战。虽然评估贫血进展至关重要，但频繁采血可能导致医源性贫血，进一步延迟恢复，并可能增加感染易感性。
