Lancet:术前铁剂治疗不能改善贫血患者术后输血需求

2020-09-07 MedSci原创 MedSci原创

在择期腹部手术前10-42天对贫血患者进行静脉注射铁剂治疗,不能降低患者术后的输血需求

术前检查中贫血患者的比例很高,并且贫血与术后不良预后相关。近日研究人员考察了对于接受择期腹部手术的贫血患者,术前铁剂治疗对减少输血需要和患者预后的影响。

研究在46个英国三级医疗护理中心开展,准备接受腹部手术并且在术前检查时发现贫血的成年参与者参与。贫血的定义为:男性血红蛋白低于130 g/L,女性血红蛋白低于120 g/L。患者在手术前10-42天接受静脉注射铁剂(1g羧麦芽糖铁)或安慰剂。研究的主要终点是输血或死亡。

487名患者参与研究,其中安慰剂组243人,羧麦芽糖铁静脉注射组244人,474名(97%)患者完成研究。安慰剂组237例患者中67例(28%)死亡或需输血,静脉铁剂组237例患者中69例(29%)发生死亡或需输血(风险比1.03)。111例安慰剂组患者接受了输血,静脉铁剂组105例(比率0.98)。

组间血红蛋白浓度变化

组间预先指定的安全终点方面无显著性差异。

研究认为,在择期腹部手术前10-42天对贫血患者进行静脉注射铁剂治疗,不能降低患者术后的输血需求。

原始出处:

Toby Richards et al. Preoperative intravenous iron to treat anaemia before major abdominal surgery (PREVENTT): a randomised, double-blind, controlled trial. Lancet. September 04, 2020.

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    2021-02-26 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1830819, encodeId=fccf183081997, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Feb 26 07:41:43 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259732, encodeId=98cb1259e32d0, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Wed Sep 09 09:41:43 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883434, encodeId=11bf8834346e, content=<a href='/topic/show?id=9fdd92442ed' target=_blank style='color:#2F92EE;'>#贫血#</a>患者<a href='/topic/show?id=0c221038e385' target=_blank style='color:#2F92EE;'>#术后输血#</a>需求,补铁没有这么快呀,另外贫血的原因甚多,缺铁也只是其中之一。CKD等各种原因均可能导致贫血的发生, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92442, encryptionId=9fdd92442ed, topicName=贫血), TopicDto(id=103873, encryptionId=0c221038e385, topicName=术后输血)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Mon Sep 07 22:38:22 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033964, encodeId=4a81103396436, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon Sep 07 21:41:43 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883377, encodeId=52ac8833e7e9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200729/2ee0ca079ce64987b1195eb6aa20a1f4/ae923a98c9704879bacdc81d9fa7479a.jpg, createdBy=a3ab5398909, createdName=ms6000001113694287, createdTime=Mon Sep 07 18:53:41 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-09 windight
  3. [GetPortalCommentsPageByObjectIdResponse(id=1830819, encodeId=fccf183081997, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Feb 26 07:41:43 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259732, encodeId=98cb1259e32d0, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Wed Sep 09 09:41:43 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883434, encodeId=11bf8834346e, content=<a href='/topic/show?id=9fdd92442ed' target=_blank style='color:#2F92EE;'>#贫血#</a>患者<a href='/topic/show?id=0c221038e385' target=_blank style='color:#2F92EE;'>#术后输血#</a>需求,补铁没有这么快呀,另外贫血的原因甚多,缺铁也只是其中之一。CKD等各种原因均可能导致贫血的发生, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92442, encryptionId=9fdd92442ed, topicName=贫血), TopicDto(id=103873, encryptionId=0c221038e385, topicName=术后输血)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Mon Sep 07 22:38:22 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033964, encodeId=4a81103396436, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon Sep 07 21:41:43 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883377, encodeId=52ac8833e7e9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200729/2ee0ca079ce64987b1195eb6aa20a1f4/ae923a98c9704879bacdc81d9fa7479a.jpg, createdBy=a3ab5398909, createdName=ms6000001113694287, createdTime=Mon Sep 07 18:53:41 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-07 lovetcm

    #贫血#患者#术后输血#需求,补铁没有这么快呀,另外贫血的原因甚多,缺铁也只是其中之一。CKD等各种原因均可能导致贫血的发生

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1830819, encodeId=fccf183081997, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Feb 26 07:41:43 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259732, encodeId=98cb1259e32d0, content=<a href='/topic/show?id=569c9382389' target=_blank style='color:#2F92EE;'>#输血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93823, encryptionId=569c9382389, topicName=输血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Wed Sep 09 09:41:43 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883434, encodeId=11bf8834346e, content=<a href='/topic/show?id=9fdd92442ed' target=_blank style='color:#2F92EE;'>#贫血#</a>患者<a href='/topic/show?id=0c221038e385' target=_blank style='color:#2F92EE;'>#术后输血#</a>需求,补铁没有这么快呀,另外贫血的原因甚多,缺铁也只是其中之一。CKD等各种原因均可能导致贫血的发生, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92442, encryptionId=9fdd92442ed, topicName=贫血), TopicDto(id=103873, encryptionId=0c221038e385, topicName=术后输血)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Mon Sep 07 22:38:22 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033964, encodeId=4a81103396436, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon Sep 07 21:41:43 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883377, encodeId=52ac8833e7e9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200729/2ee0ca079ce64987b1195eb6aa20a1f4/ae923a98c9704879bacdc81d9fa7479a.jpg, createdBy=a3ab5398909, createdName=ms6000001113694287, createdTime=Mon Sep 07 18:53:41 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-07 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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    2020-09-07 ms6000001113694287

    学习了

    0

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