Nakae Y, Sonoda H, Miyabe M, Kawamata M, Sakakibara N, Kawana S, Namiki A
Department of Anesthesia, Kushiro City General Hospital.
Masui. 1995 Oct;44(10):1362-8.
This study evaluated whether a combination of recombinant human erythropoietin (rHuEPO) and hemodilutional autologous transfusion could reduce homologous blood transfusion in 37 patients who underwent elective urological surgery. A single dose of 6000 IU rHuEPO was administered 2 weeks before operation to patients whose preoperative hemoglobin was less than 12.0 g.dl-1 (8.5-12.0 g.dl-1) (EPO group, n = 15) and compared these with control subjects whose preoperative hemoglobin was more than 12.0 g.dl-1 (non-EPO group, n = 22). Both hemoglobin and hematocrit levels after administration of rHuEPO in the EPO group increased significantly to the same levels as in those in the non-EPO group and remained at these levels. The mean volume of donated autologous blood was 980 g in the EPO group and 110 g in the non-EPO group. The mean surgical blood loss was 1330 g in the EPO group and 1120 g in the non-EPO group. No homologous blood transfusion was required in 80 percent of the cases in both groups: however, homologous transfusions were added to 3 cases in the EPO group and 4 cases in the non-EPO group whose surgical blood loss was over 2500 g. We conclude that the combination of preoperative rHuEPO treatment and hemodilutional autologous transfusion can reduce homologous transfusion during surgery in anemic patients.
本研究评估了重组人促红细胞生成素(rHuEPO)与血液稀释自体输血联合应用能否减少37例行择期泌尿外科手术患者的同种异体输血。对术前血红蛋白低于12.0 g.dl-1(8.5 - 12.0 g.dl-1)的患者(EPO组,n = 15)在手术前2周给予单剂量6000 IU rHuEPO,并将其与术前血红蛋白高于12.0 g.dl-1的对照组患者(非EPO组,n = 22)进行比较。EPO组给予rHuEPO后血红蛋白和血细胞比容水平均显著升高至与非EPO组相同水平,并维持在这些水平。EPO组自体献血的平均量为980 g,非EPO组为110 g。EPO组手术平均失血量为1330 g,非EPO组为1120 g。两组80%的病例均无需同种异体输血;然而,手术失血量超过2500 g的患者中,EPO组有3例、非EPO组有4例接受了同种异体输血。我们得出结论,术前rHuEPO治疗与血液稀释自体输血联合应用可减少贫血患者手术期间的同种异体输血。