文章：

术前贫血患者实施静脉铁剂治疗血液管理后的术后结果：一项针对1294例结直肠癌患者的前瞻性队列研究

Postoperative Results After Patient Blood Management with Intravenous Iron Treatment Implementation for Preoperative Anemia: Prospective Cohort Study of 1294 Colorectal Cancer Patients

原文发布日期：7 March 2025

DOI: 10.3390/cancers17060912

类型: Article

开放获取: 是

英文摘要：

Background:PA is frequent in CRC patients and known to be detrimental to surgical outcomes. PBM systems promote rational use of blood products and PA treatment with IVI, which could potentially improve postoperative results and the need for RBCT.Objective:To evaluate the effectiveness of Intravenous Iron (IVI) within a Patient Blood Management (PBM) pathway in Colorectal Cancer (CRC) patients with Preoperative Anemia (PA). To analyze surgical results after treatment and the need for Red Blood Cell Transfusion (RBCT) after surgery.Methods:Cohort study of CRC patients between 2012 and 2018, divided into groups: non-anemic patients (Hemoglobin Hb > 13 g/dL, Group 1), mildly anemic patients (Hb 12–13 mg/dL, Group 2), and patients treated with IVI (Hb < 12 mg/dL or Hb 12–13 mg/dL with risk factors, Group 3). Effectiveness of IVI treatment measured based on differences in Hb changes. Surgical complications were assessed and compared among groups, as well as the RBCT rate. The latter was also compared between Group 3 patients and those receiving preoperative RBCT.Results:Group 3 presented with a baseline Hb of 9.9 (±1.5) mg/dL with an increase of 1.2 (±1.9) mg/dL after treatment, which endured until discharge. Clavien-Dindo III-IV complications were 6.5%, and 30-day Mortality was 1.4% in all the series, without differences among Groups. RBCT rate in Group 3 patients was 21.6%, significantly lower than that of patients receiving preoperative RBCT (32.6%).Conclusions:IVI is a safe and effective measure for a fast PA correction in CCR patients and could potentially reduce postoperative RBCT rates.

摘要翻译： 

背景：结直肠癌患者中术前贫血较为常见，且已知对手术预后有不利影响。患者血液管理系统促进血液制品的合理使用及静脉铁剂治疗术前贫血，这可能改善术后结果并减少红细胞输注需求。 目的：评估在结直肠癌合并术前贫血患者中，静脉铁剂治疗在患者血液管理路径中的有效性，分析治疗后的手术结果及术后红细胞输注需求。 方法：对2012年至2018年间的结直肠癌患者进行队列研究，分为三组：非贫血患者（血红蛋白>13 g/dL，第1组）、轻度贫血患者（血红蛋白12-13 g/dL，第2组）以及接受静脉铁剂治疗的患者（血红蛋白<12 g/dL或血红蛋白12-13 g/dL伴有危险因素，第3组）。通过血红蛋白变化差异评估静脉铁剂治疗效果。评估并比较各组间的手术并发症及红细胞输注率，同时将第3组患者与接受术前红细胞输注的患者进行输注率比较。 结果：第3组患者基线血红蛋白为9.9（±1.5）g/dL，治疗后升高1.2（±1.9）g/dL，该效果持续至出院。全队列中Clavien-Dindo III-IV级并发症发生率为6.5%，30天死亡率为1.4%，组间无显著差异。第3组患者红细胞输注率为21.6%，显著低于接受术前红细胞输注患者的32.6%。 结论：静脉铁剂是快速纠正结直肠癌患者术前贫血的安全有效措施，并可能降低术后红细胞输注率。

原文链接：

Postoperative Results After Patient Blood Management with Intravenous Iron Treatment Implementation for Preoperative Anemia: Prospective Cohort Study of 1294 Colorectal Cancer Patients