Efficacy and safety of erythropoietin in isolated spinal metastasis patients with total en bloc spondylectomy surgery: a case–control study
Efficacy and safety of erythropoietin in isolated spinal metastasis patients with total en bloc spondylectomy surgery: a case–control study
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DOI：
10.1007/s00586-023-07554-2
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发表时间：
2023-01
影响因子：
2.8
通讯作者：
Shuang-Sheng Cao;Kai Lv;Cheng Peng;Guangjian Bai;Xin Gao;Jing Wang;Jiashi Cao;Rende Ning;Jianjun Chu;Tielong Liu
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文献类型：
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作者：
Shuang-Sheng Cao;Kai Lv;Cheng Peng;Guangjian Bai;Xin Gao;Jing Wang;Jiashi Cao;Rende Ning;Jianjun Chu;Tielong Liu
本研究的目的是通过评估血液学参数、输血量、术后并发症、无复发生存期（RFS）和总生存期（OS），确定短期和大剂量使用促红细胞生成素（EPO）对脊柱孤立转移患者进行全脊椎切除术（TES）手术的效果。选择93例孤立性脊柱转移瘤患者，并根据所用治疗方法分为2组（EPO + TXA（氨甲环酸）组，n= 47; TXA组，n= 46）。评价指标包括血红蛋白（Hb）、红细胞压积（Hct）、红细胞（RBC）、RFS、OS、术后并发症、术后Frankel分级、引流量、输血率、平均输血量。两组RFS、OS、术后并发症、术后Frankel分级、引流量、输血率差异均无统计学意义（P> 0.05）。然而，EPO + TXA组患者在术后第1、2、3和5天的Hb、Hct和RBC值显著高于TXA组。EPO + TXA组的平均输血量明显低于TXA组（P= 0.011）。结论围手术期短期大剂量使用EPO可改善TES手术孤立性脊柱转移瘤患者贫血相关的血液学指标，减少输血量，且不增加深静脉血栓形成和肿瘤进展的风险。
ObjectiveThe purpose of our study is to identify the effect of short-term and high-dose use of erythropoietin (EPO) in spinal isolated metastatic patients with Total en bloc spondylectomy (TES) surgery by assessing hematological parameters, transfusion volume, postoperative complications, recurrence-free survival (RFS), and overall survival (OS).MethodsFrom January 2015 and January 2022, 93 isolated spinal metastasis patients were selected and separated into 2 groups based on the treatment method used (EPO + TXA (Tranexamic acid) group,n= 47; and TXA group,n= 46). Indexes for evaluation included hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), RFS, OS, postoperative complications, postoperative Frankel Grade, drainage volume, transfusion rate, and mean units transfused.ResultsThe average follow-up duration was 38.13 months. There was no significant difference (P> 0.05) in RFS, OS, postoperative complications, postoperative Frankel Grade, drainage volume, and transfusion rate between the two groups. However, patients in EPO + TXA group have significantly higher Hb, Hct, and RBC values than those in the TXA group on postoperative days 1, 2, 3, and 5. Moreover, the mean transfusion volume in EPO + TXA group was significantly lower than those in the TXA group (P= 0.011).ConclusionsPerioperative short-term and high-dose administration of EPO could improve the anemia-related hematological parameters and reduce the requirement for blood transfusion without increasing the risk of deep vein thrombosis and tumor progression in solitary spinal metastatic patients with TES surgery.