促红细胞生成素治疗退行性腰椎管狭窄患者的疗效和安全性：一项病例对照研究

IF 0.4 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-04-24 DOI:10.1016/j.inat.2025.102031

Dong Wang , Ying Liu , Shuang Cao , Ying Wu , Zhihao Ni , Rende Ning

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Still, there was little information on the application of EPO in patients with DLSS undergoing multi-level LIF.</div><div>Methods.</div><div>458 DLSS patients between January 2015 and December 2022 were selected and divided into EPO (group A), n = 112, and no EPO (group B), n = 105, according to treatment technique. Evaluation indexes included hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), postoperative complications, operative time, intraoperative bleeding, drainage volume, mean transfusion volume, transfusion rate, and length of stay.</div><div>Results.</div><div>The mean follow-up time was 21.7 months (18–24 months). Postoperative complications, surgical time, intraoperative bleeding, and drainage volume were not statistically different across groups. The Hb, Hct, and RBC values on postoperative days 1, 3, and 5 were significantly higher in group A than in B, and the difference was statistically significant (P < 0.05). 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引用次数: 0

摘要

通过评估平均输血量、输血率、血液学参数、术后并发症和住院时间，评估短期和大剂量应用促红细胞生成素（EPO）对接受多层次腰椎椎间融合术（LIF）的退行性腰椎管狭窄症（DLSS）患者的疗效。背景数据摘要：已有报道证实 EPO 在神经外科、心脏外科和骨科等大型手术中的有效性和安全性。方法：选取2015年1月至2022年12月期间的458例DLSS患者，根据治疗技术分为EPO（A组），n = 112；无EPO（B组），n = 105。评价指标包括血红蛋白（Hb）、血细胞比容（Hct）、红细胞（RBC）、术后并发症、手术时间、术中出血量、引流量、平均输血量、输血率和住院时间。各组的术后并发症、手术时间、术中出血量和引流量无统计学差异。术后第 1、3 和 5 天，A 组的 Hb、Hct 和 RBC 值明显高于 B 组，差异有统计学意义（P < 0.05）。A 组的平均输血率明显低于 B 组（P < 0.001）。A 组的平均输血量明显低于 B 组（P < 0.001）。结论：接受多级 LIF 的 DLSS 患者围手术期短期大剂量 EPO 可改善贫血相关的血液学指标，减少输血需求，缩短住院时间，同时不会增加深静脉血栓或伤口感染。

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Efficacy and safety of erythropoietin in patients with degenerative lumbar spinal stenosis undergoing multi-level lumbar interbody fusion: A case-control study

Study Design.

Retrospective case-control study.

Objective

To assess the efficacy of short-term and high-dose application of erythropoietin (EPO) in patients with degenerative lumbar spinal stenosis (DLSS) undergoing multi-level lumbar interbody fusion (LIF) by assessing mean transfusion volume, transfusion rate, hematologic parameters, postoperative complications, and length of stay.

Summary of Background Data.

It has been reported to confirm the efficacy and safety of EPO in major surgeries like neurosurgery, cardiac surgery, and orthopedics. Still, there was little information on the application of EPO in patients with DLSS undergoing multi-level LIF.

Methods.

458 DLSS patients between January 2015 and December 2022 were selected and divided into EPO (group A), n = 112, and no EPO (group B), n = 105, according to treatment technique. Evaluation indexes included hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), postoperative complications, operative time, intraoperative bleeding, drainage volume, mean transfusion volume, transfusion rate, and length of stay.

Results.

The mean follow-up time was 21.7 months (18–24 months). Postoperative complications, surgical time, intraoperative bleeding, and drainage volume were not statistically different across groups. The Hb, Hct, and RBC values on postoperative days 1, 3, and 5 were significantly higher in group A than in B, and the difference was statistically significant (P < 0.05). The mean transfusion rate was significantly lower in group A than in B (P < 0.001). The mean transfusion volume was significantly lower in group A than in B (P < 0.001). The length of stay was significantly lower in group A than in B (P < 0.001).

Conclusion.

Short-term and high-dose perioperative EPO in DLSS patients undergoing multi-level LIF improves anemia-related hematologic parameters, reduces transfusion requirements, and shortens hospital stay without increasing deep vein thrombosis or wound infection.

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