Dudrick S J, O'Donnell J J, Raleigh D P, Matheny R G, Unkel S P
Arch Surg. 1985 Jun;120(6):721-7. doi: 10.1001/archsurg.1985.01390300067012.
Optimal parenteral nutritional support, concomitant with replacement doses of intravenous iron dextran injection, can be safe, effective, and lifesaving for severely anemic patients who are unable to receive blood transfusions. Six patients who had sustained massive acute blood loss and two who had severe chronic anemia received as much as 140 mL of iron dextran injection intravenously. The average initial hemoglobin level in the acute group was 5.0 g/dL (range, 2.6 to 8.4 g/dL) and increased to an average of 10.6 g/dL (range, 7.5 to 12.8 g/dL) in 23 days (range, 17 to 30 days); the hemoglobin level in the chronic group was 3.8 g/dL and increased to 10.6 g/dL over an average period of 121 days. Two total abdominal colectomies, a right transverse colectomy and fistulectomy, a pyloroplasty and vagotomy, and a highly selective vagotomy were accomplished without complications in five of the patients. There were no adverse reactions to the hematopoietic therapy.
对于无法接受输血的严重贫血患者，最佳的肠外营养支持与静脉注射右旋糖酐铁补充剂量相结合，可能是安全、有效的，甚至能挽救生命。6例遭受大量急性失血的患者和2例患有严重慢性贫血的患者静脉注射了多达140 mL的右旋糖酐铁注射液。急性组的平均初始血红蛋白水平为5.0 g/dL（范围为2.6至8.4 g/dL），并在23天（范围为17至30天）内升至平均10.6 g/dL（范围为7.5至12.8 g/dL）；慢性组的血红蛋白水平为3.8 g/dL，并在平均121天内升至10.6 g/dL。5例患者成功进行了2例全腹结肠切除术、1例右半横结肠切除术和瘘管切除术、1例幽门成形术和迷走神经切断术以及1例高选择性迷走神经切断术，均无并发症。造血治疗未出现不良反应。
