摘   要：目的  評(píng)價(jià)重組人促紅細(xì)胞生成素在肝移植圍術(shù)期中的效果及安全性。方法  回顧分析我院2015年9月～2016年12月原位肝移植89例患者的化驗(yàn)檢查、用藥情況及圍術(shù)期輸血情況，排除二次肝移植手術(shù)患者、死亡患者、術(shù)中輸血>50 U患者，根據(jù)圍術(shù)期是否應(yīng)用rHuEPO，分為EPO組和對(duì)照組。EPO組入院后根據(jù)圍術(shù)期貧血情況皮下注射 rHuEPO 10000 U/次，1 次/d或1次/2 d;對(duì)照組入院后未用rHuEPO。觀察兩組患者術(shù)后血紅蛋白、紅細(xì)胞計(jì)數(shù)、網(wǎng)織紅細(xì)胞計(jì)數(shù)以及輸血量的對(duì)比情況。結(jié)果  ①EPO組患者經(jīng)治療后，術(shù)后3 d（T1）、術(shù)后7 d（T2）、術(shù)后15 d（T3）及術(shù)后1個(gè)月（T4）與術(shù)前基礎(chǔ)值（T0）比較，Hb變化不大，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;對(duì)照組Hb T1、T2、T3、T4與T0比較明顯降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.01）;EPO組T0時(shí)點(diǎn)Hb明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.01），在T3、T4時(shí)點(diǎn)Hb高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。②EPO組患者經(jīng)治療后，T1、T2、T3、T4與T0比較，RBC計(jì)數(shù)差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;對(duì)照組RBC T1、T2、T3、T4與T0比較降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;對(duì)照組T1、T2、T3、T4時(shí)點(diǎn)RBC低于EPO 組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。③EPO組患者經(jīng)治療后，網(wǎng)織紅細(xì)胞計(jì)數(shù)（RET）T3、T4時(shí)點(diǎn)較對(duì)照組明顯上升，差異有統(tǒng)計(jì)學(xué)意義（P<0.01）; EPO組T3、T4時(shí)點(diǎn)與T0比較，RET升高，差異有統(tǒng)計(jì)學(xué)意義（P<0.01）;對(duì)照組RET 在 T1、T2、T3、T4與T0比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;組間比較，EPO組T3、T4時(shí)點(diǎn)RET 明顯高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。結(jié)論  肝移植貧血患者在圍術(shù)期皮下注射rHuEPO，術(shù)后1個(gè)月患者的貧血改善好于對(duì)照組，提示rHuEPO對(duì)肝移植貧血的重癥患者安全、有效。
　　關(guān)鍵詞：重組人促紅細(xì)胞生成素;肝移植;貧血
　　中圖分類號(hào)：R656;R619+.1                         文獻(xiàn)標(biāo)識(shí)碼：A                              DOI：10.3969/j.issn.1006-1959.2018.05.024
　　文章編號(hào)：1006-1959（2018）05-0074-04
　　Study on the Effect and Safety of EPO in Perioperative Period of Liver Transplantation
　　JIA Peng-fei1，YUAN Li1，ZHAO Li-peng1，ZANG Yun-jin2，XUE Xin1
　�。―epartment of Anesthesiology1，Department of Organ Transplantation2，Affiliated Hospital of Qingdao University，Qingdao 266003，Shandong，China）
　　Abstract：Objective  To evaluate the effect and safety of recombinant human erythropoietin（RH）in the perioperative period of liver transplantation.Methods  89 cases of orthotopic liver transplantation from September 2015 to December 2016 in our hospital were retrospectively analyzed，including laboratory examination，drug use and perioperative blood transfusion，excluding secondary liver transplantation patients，dead patients，and patients with intraoperative blood transfusion>50 U.According to whether or not to use rHuEPO during perioperative period，the EPO group and control group.Group EPO was subcutaneously injected with rHuEPO 10000 U/，1 times/d or 1/2 d，and the control group did not use rHuEPO after admission.The comparison of hemoglobin，red blood cell count， reticulocyte count and blood transfusion after operation was observed in the two groups.Results  EPO group of patients after treatment， postoperative 3 d（T1），7 d after operation（T2），15 d after operation（T3）and 1 months after surgery（T4）with preoperative value（T0），Hb changed little，there was no statistically significant difference（P>0.05）the control group Hb;T1，T2，T3，T4 and T0 significantly decreased， the difference was statistically significant（P<0.01）;EPO group at T0 Hb was significantly lower than the control group，the difference was statistically significant（P<0.01），in T3，T4 at Hb was higher than the control group，the difference was statistically significant（P< 0.05）.②EPO group of patients after treatment，T1，T2，T3，T4 and T0，there was no significant difference between RBC count（P>0.05）;the control group RBC T1，T2，T3，T4 and T0 decreased，the difference was statistically significant（P<0.05）;control group T1，T2，T3，T4 at RBC lower than the EPO group，the difference was statistically significant（P<0.05）.③After treatment，the time of reticulocyte count （RET）T3 and T4 in group EPO was significantly higher than that in the control group（P<0.01）.Compared with T0 in EPO group，there was a statistically significant increase in RET and RET（P<0.01）.There was no significant difference in RET，T1，T2，T3 and T4 between the control group and T0 group（P>0.05）.In group comparison，the time point of T3 and T4 in group EPO was significantly higher than that in the control group，and the difference was statistically significant（P<0.01）.Conclusion  The hypodermic injection of rHuEPO in perioperative period is better than that in the control group at 1 month after operation.It indicates that rHuEPO is safe and effective for severe patients with anemia after liver transplantation.

相關(guān)熱詞搜索：安全性 效果 肝移植 研究 EPO