The Effect of Intraoperative Ferric Carboxymaltose in Joint Arthroplasty Patients: A Randomized Trial
The Effect of Intraoperative Ferric Carboxymaltose in Joint Arthroplasty Patients: A Randomized Trial
复制标题
术中羧基麦芽糖铁对关节置换术患者的影响：一项随机试验
作者：
Hee;Tae;Ha;Y. Ro;H. Jang;W. Koh
本研究评估了全膝关节和全髋关节置换术患者术中大剂量静脉铁剂治疗在促进术后贫血恢复和降低输血率方面的有效性。这项前瞻性随机对照研究涉及58名受试者。F组静脉注射羧基麦芽糖铁1000 mg，C组静脉注射生理盐水。记录血红蛋白（Hb）、红细胞压积、铁代谢变量、输血率、动脉氧分压和氧分数（PaO 2/FiO 2）比值的变化。每组29例。从基线到术后1个月，F组Hb水平的变化高于C组（0.3 ± 1.0 g/dl vs. −0.8 ± 0.8 g/dl，p < 0.001）。术后功能性缺铁发生率C组为0%，对照组为48.3%，P < 0.001。两组术后贫血发生率、输血率及P/F比值无显著性差异。本研究提示，在下肢全关节置换术中，术中大剂量的羧基麦芽糖铁可以促进术后贫血的恢复。尽管无法预防术后贫血或输血的发生，但这种治疗似乎克服了手术相关的铁可用性下降。
This study assessed the efficacy of intraoperative high-dose intravenous iron therapy in facilitating recovery from postoperative anemia and reducing the transfusion rate in patients with total knee and total hip arthroplasty. This prospective randomized controlled study involved 58 subjects. Group F received 1000 mg intravenous ferric carboxymaltose and Group C received normal saline. The changes in hemoglobin (Hb), hematocrit, iron metabolism variables, transfusion rates, and the arterial partial pressure of oxygen and the fraction of oxygen (PaO2/FiO2) ratio were recorded. There were 29 patients of each group. The change in Hb levels from baseline to 1 month post-surgery was higher in Group F than in Group C (0.3 ± 1.0 g/dl vs. −0.8 ± 0.8 g/dl, p < 0.001). Functional iron deficiency occurred more frequently in Group C (0% vs. 48.3%, p < 0.001) after the operation. The incidence of postoperative anemia, transfusion rate and P/F ratio did not significantly differ between the two groups. This study suggests that intraoperative high-dose ferric carboxymaltose during lower limb total arthroplasty can facilitate the recovery from postoperative anemia. Although it could not prevent the occurrence of postoperative anemia or the administration of transfusion, this treatment seemed to overcome surgery-related decrease of iron availability.