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目的:观察重组人促红细胞生成素(rh-EPO)在储存式自体输血患者红细胞动员中应用价值。方法:以香河县人民医院行储存式自体输血的82例患者为研究对象,按入院顺序分为2组,奇数入对照组,偶数入rh-EPO组,每组41例。2组患者分别于术前7d和3d采血400 ml,于术中或术后回输给患者,同时于采血前1周补充铁剂至最末一次采血后数周或数月。rh-EPO组于术前10 d至术后第7天注射rh-EPO 150 U·kg~(-1)·d~(-1),对照组不应用rh-EPO。观察2组患者术前术后RBC、Hb和Hct的变化以及不良反应发生情况。结果:①2组术前1h、术后第1和第5天RBC、Hb及Hct明显降低,与第1次采血前比较,差异有统计学意义(P<0.05)。rh-EPO组与对照组比较,术后第1、5天RBC、Hb及Hct明显升高,差异有统计学意义(P<0.05);②在自体血回输过程2组患者生命体征平稳、没有出现寒战、发热、过敏等输血不良反应,均顺利完成手术。rh-EPO组患者未发生血黏度增高、血栓等并发症。结论:rh-EPO应用于储存式自体输血患者红细胞动员,可有效改善患者术中及术后的贫血状况。
Objective: To observe the value of recombinant human erythropoietin (rh-EPO) in the mobilization of red blood cells in patients with autologus transfusion. Methods: Eighty-two patients with storage-type autologous blood transfusion in Xianghe People’s Hospital were divided into two groups according to the order of hospitalization. They were randomly assigned to the control group and even to rh-EPO group, 41 cases in each group. Two groups of patients were collected 400 ml before and 7 days and 3 days before operation, respectively, and were transfused intraoperatively or postoperatively. Patients were also given iron supplementation one week before blood sampling to several weeks or months after the last blood sampling. In the rh-EPO group, rh-EPO 150 U · kg -1 d -1 was injected 10 days before and 7 days after the operation, while rh-EPO was not used in the control group. The changes of RBC, Hb and Hct and the occurrence of adverse reactions in two groups before and after operation were observed. Results: ① The levels of RBC, Hb and Hct decreased significantly at 1 hour before operation and at 1 and 5 days after operation in group 2 compared with those before the first blood collection (P <0.05). Compared with the control group, the RBC, Hb and Hct levels in rh-EPO group were significantly increased on the first and fifth day after operation (P <0.05); ②The vital signs of the two groups were stable during the autologous blood transfusion, No chills, fever, allergies and other transfusion adverse reactions, were successfully completed the operation. Patients in rh-EPO group had no complications such as increased blood viscosity and thrombosis. Conclusion: rh-EPO can be used to mobilize red blood cells in patients with autologous blood transfusion, which can effectively improve the anemia in patients during and after operation.