Abstract:Objective To investigate the effect of erythropoietin (EPO) combined with iron on anemia after hip and knee arthroplasty in different ages.Methods 149 patients with total hip arthroplasty (THA) and total knee arthroplasty (TKA) treated in XuanwuHospital of Capital Medical University were analyzed from May 2013 to December 2014,retrospectively.There were 42 males and 107 females,aged from 51 to 92 years old,with an average of (72.8±8.52) years old.Hip arthroplasty was performed in 74 cases and knee arthroplasty in 75 cases.According to the age of the patients,the patients were divided into two groups: the elderly group (≥65 years old,n=121) and the non-elderly group (<65 years old,n=28).The patients in both groups were treated with EPO combined with iron during the perioperative period.The baseline information of patients,perioperative laboratory indexes,anemia rate before and after operation,allogeneic blood transfusion rate and blood loss volume were recorded.The blood volume of patients was calculated by Nadler equation and the hidden blood loss volume was calculated by Gross equation for statistical analysis.Results The preoperative anemia rate in the elderly group was 24.0%,which was significantly higher than 7.1% in the non-elderly group(P<0.05).The decrease level of hemoglobin (Hb) on the 1st,3rd and 5th day before and after operation in the elderly group was 23(12,30)g/L、29(18,38)g/L、26(15,37)g/L,respectively,which was significantly lower than that in the non-elderly group 30(22,36)g/L、38(29,49)g/L、32(23,45)g/L (P<0.05).The rate of allogeneic blood transfusion:43.8%,in the elderly group were significantly higher than those in the non-elderly group 21.4%(P<0.05).Blood loss:the total blood loss in the elderly group was 1 120(831,1 483)vs 1 087(821,1 480)mL,hidden blood loss 686(430,1 066)vs 505(414,1 116)mL,hidden blood loss ratio 61(51,75)vs 61(45,74)%,dominant blood loss 400(300,500) vs 440(205,558)mL,the difference was not statistically significant(P>0.05).Conclusion The preoperative anemia rate,allogeneic blood transfusion rate and blood transfusion volume in elderly patients with joint replacement are higher than those in non-elderly patients,and the blood management effect of EPO combined with iron is not good for the elderly.
安帅 *,李佳义 *,李征,武京伟,曹光磊,冯明利 *,沈惠良,刘利民,鲁世保. 促红细胞生成素对不同年龄关节置换患者围术期贫血的影响[J]. 实用骨科杂志, 2020, 26(8): 688-692.
An Shuai,Li Jiayi,Li Zheng,et al. Study on the Efficacy of Erythropoietin in the Treatment of Perioperative Anemia in Patients with Joint Replacement of Different Ages. sygkzz, 2020, 26(8): 688-692.
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