Initial unilateral total knee arthroplasty with intravenous or oral administration of sucrose: Comparison of hemorrhage and transfusion rate in peri-replacement period

doi:10.3877/cma.j.issn.2096-0263.2020.03.005

Abstract

Abstract:

Objective

To investigate the effect of intravenous and oral application of iron sucrose on perioperative blood loss and transfusion rate in patients undergoing primary unilateral total knee arthroplasty.

Methods

120 patients who underwent primary unilateral knee arthroplasty in Xinjiang Uygur Autonomous Region People's Hospital from July 2017 to June 2018 were randomly divided into three groups, 40 patients in intravenous iron sucrose group, 40 patients in oral iron sucrose group and 40 patients in blank control group. The total amount of iron sucrose used in the first two groups was 300 mg/d, 3 days before operation and 4 days after operation. The maximum decrease of RBC specific volume, hemoglobin, total perioperative blood loss and transfusion rate were compared among the three groups.

Result

The blood transfusion rate, the average maximum decrease of HGB, the average total blood loss and the average decrease of Hct in intravenous iron sucrose group were significantly lower than those in oral iron sucrose group and blank group (P<0.01). There was no significant difference between oral iron sucrose group and blank group in blood transfusion rate, perioperative total blood loss, the maximum decrease of HGB and the maximum decrease of Hct. There was no statistical significance (P>0.05).

Conclusion

Intravenous application of iron sucrose can significantly reduce the amount of blood loss after knee arthroplasty, and can significantly reduce the rate of blood transfusion, the effect is better than the other two groups. There was no significant difference in blood loss and transfusion rate between oral iron sucrose group and blank group.

Key words: Iron sucrose, Arthroplasty, replacement, knee, Blood transfusion

Wenzheng Zhou, Zutao Li, Qingbin Zhao, Jungang Sun. Initial unilateral total knee arthroplasty with intravenous or oral administration of sucrose: Comparison of hemorrhage and transfusion rate in peri-replacement period[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2020, 06(03): 148-152.

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References 20

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组别	例数	性别构成（例，男/女）	年龄（岁， ±s）	BMI（kg/m²， ±s）	疾病构成（例，OA/RA）	手术时间（min， ±s）	术前HCT（%， ±s）	术前HGB（g/L， ±s）
空白对照组	40	19/21	62±15	23.0±2.4	26/14	66±5	0.409±0.025	138±10
静脉用药组	40	22/18	60±12	23.9±3.3	31/9	67±6	0.406±0.039	138±13
口服用药组	40	20/20	58±15	24.2±3.2	24/16	61±4	0.415±0.031	137±12
统计值		χ²=0.201	F=0.324	F=0.574	χ²=0.737	F=1.431	F=0.547	F=0.568
P值		0.871	0.544	0.221	0.151	0.081	0.112	0.132

组别	例数	性别构成（例，男/女）	年龄（岁， ±s）	BMI（kg/m²， ±s）	疾病构成（例，OA/RA）	手术时间（min， ±s）	术前HCT（%， ±s）	术前HGB（g/L， ±s）
空白对照组	40	19/21	62±15	23.0±2.4	26/14	66±5	0.409±0.025	138±10
静脉用药组	40	22/18	60±12	23.9±3.3	31/9	67±6	0.406±0.039	138±13
口服用药组	40	20/20	58±15	24.2±3.2	24/16	61±4	0.415±0.031	137±12
统计值		χ²=0.201	F=0.324	F=0.574	χ²=0.737	F=1.431	F=0.547	F=0.568
P值		0.871	0.544	0.221	0.151	0.081	0.112	0.132

组别	例数	总失血量（ml）	主要终点事件发生率	次要终点事件发生率
静脉用药组	40	729±128	10%	7.50%
口服用药组	40	1 045±164	30%	25%
空白对照组	40	1 057±163	27.50%	27.50%
F值		2.342	1.762	1.762
P值		0.001	0.001	0.001

组别	例数	总失血量（ml）	主要终点事件发生率	次要终点事件发生率
静脉用药组	40	729±128	10%	7.50%
口服用药组	40	1 045±164	30%	25%
空白对照组	40	1 057±163	27.50%	27.50%
F值		2.342	1.762	1.762
P值		0.001	0.001	0.001

组别	总失血量（q值/P值）	主要终点事件发生率（q值/P值）	次要终点事件发生率（q值/P值）
静脉用药组vs口服用药组	2.342/0.001	1.762/0.017	1.263/0.035
静脉用药组vs空白对照组	3.231/0.001	1.683/0.015	1.732/0.019
口服用药组vs空白对照组	0.521/0.722	4.132/0.098	4.538/0.081

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