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Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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 B12 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).
CONCLUSIONS: 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 B12 administration during the early postoperative period.
METHODS: 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.
RESULTS: 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 B12 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).
CONCLUSIONS: 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 B12 administration during the early postoperative period.
摘要：
背景：术后贫血是不良手术结局的危险因素。我们的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快速纠正贫血的作用。
方法：前瞻性纳入择期骨科手术患者，随机分为三组：对照组（安慰剂），第1组（IV铁单一疗法），和第2组[联合IV铁和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（PODs）进行血液检查。
结果：与基线相比，所有组的血红蛋白（Hb）浓度均明显降低，术后Hb浓度组间差异无统计学意义(p>0.05)。血清促红细胞生成素，铁蛋白,和维生素B12水平，所有组的网织红细胞计数均超过正常范围。各组术后血清铁水平均显著降低(p<0.05)。两组hepcidin水平无显著差异(p>0.05)。
结论：术后联合静脉铁剂和rHuEPO治疗对纠正骨科手术患者术后贫血无效。除了在手术的第一周实现更高的网织红细胞计数。用rHuEPO没有实现储存铁动员的改善。我们进一步建议在术后早期不要服用维生素B12。
方法：前瞻性纳入择期骨科手术患者，随机分为三组：对照组（安慰剂），第1组（IV铁单一疗法），和第2组[联合IV铁和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（PODs）进行血液检查。
结果：与基线相比，所有组的血红蛋白（Hb）浓度均明显降低，术后Hb浓度组间差异无统计学意义(p>0.05)。血清促红细胞生成素，铁蛋白,和维生素B12水平，所有组的网织红细胞计数均超过正常范围。各组术后血清铁水平均显著降低(p<0.05)。两组hepcidin水平无显著差异(p>0.05)。
结论：术后联合静脉铁剂和rHuEPO治疗对纠正骨科手术患者术后贫血无效。除了在手术的第一周实现更高的网织红细胞计数。用rHuEPO没有实现储存铁动员的改善。我们进一步建议在术后早期不要服用维生素B12。
