ObjectiveTo explore the postoperative effect of preoperative anemia on patients undergoing unilateral total hip arthroplasty (THA).MethodsA total of 200 patients undergoing unilateral primary THA from July to September 2018 were selected. According to the preoperative hemoglobin level and the World Health Organization definition of anemia (hemoglobin below 120 g/L for women and below 130 g/L for men), the patients were divided into the non-anemia group and the anemia group. All anemia patients were given dietary guidance and balanced diet before the operation, and no drug treatment was given. Both groups adopted accelerated rehabilitation strategy during the perioperative period, and postoperative anemia was treated according to a unified standard. The intraoperative blood loss and length of operation of the two groups were recorded. The presence of anemia on the first postoperative day, postoperative blood transfusion rate, incidence of postoperative complications (hypotension, nausea and vomiting on the first postoperative day, and infection-related unplanned readmission within 90 days after discharge), range of motion of the hip joint (hip flexion and hip abduction), and length of hospital stay were compared between the two groups.ResultsIn the 200 patients, 51 (25.50%) presented anemia before surgery and 149 did not. There were 114 cases developing mild anemia and 7 cases developing moderate anemia after surgery in the non-anemia group, with an anemia incidence of 81.21%; in the anemia group, there were 30 cases of mild anemia and 20 cases of moderate anemia, and 1 case did not have anemia after surgery. The postoperative transfusion rates of the non-anemia group and the anemia group were 2.01% and 11.76%, respectively, and the incidences of postoperative complications were 7.38% and 35.29%, respectively; the differences were statistically significant (P<0.05). However, there was no statistically significant difference in hip mobility or length of hospital stay between the two groups (P>0.05).ConclusionsQuite a few patients undergoing THA have anemia before surgery. The incidence of postoperative anemia is high due to the trauma and massive bleeding of the operation, and preoperative anemia will aggravate anemia after surgery. Preoperative anemia can increase the perioperative transfusion rate of THA patients, increase the incidence of postoperative complications, and affect the hospitalization experience of patients.
COPD 是一種可預防、可治療, 以氣流不完全可逆受限并呈進行性發展為特征的疾病, 與肺部對有害氣體或有毒顆粒的異常炎癥反應有關。在全球范圍內COPD 是引起死亡和功能致殘的主要疾病之一。COPD 在全球患病率和死亡率位居第四, 并呈不斷上升的趨勢[1] 。本病具有明顯的肺外效應, 包括引起全身系統性炎癥、代謝改變、神經激素激活,以及對肌肉骨骼、心血管系統等其他系統的影響等[2] 。既往認為COPD 僅引起紅細胞增多, 但近期研究發現COPD 引起的系統性炎癥可影響紅細胞的生成, 貧血亦同樣存在于部分COPD 患者。目前認為, COPD導致的貧血與其他許多慢性疾病如慢性心衰一樣, 同屬于一種慢性病性貧血( anemia of chronic disease, ACD) , 稱為COPD 相關性貧血, 其患病率高于繼發性紅細胞增多癥在COPD 的患病率[3-5] 。本文就COPD 相關性貧血的流行病學概況、病理生理機制、臨床重要性及干預的最新研究進展如下綜述。
ObjectiveTo explore the clinical manifestations, pathogenesis, prognosis and the therapeutic modalities of the patients with solid tumors combined with remarkable hematologic abnormalities. MethodsGastric cancer in a paitnet was diagnosed by endoscopy as well as pathological biopsy and myeloproliferative neoplasms (MPNs) were excluded through bone marrow examinations. Therefore, the primary and metastatic malignancies were excised. ResultsAlthough surgical operation improved the hematologic changes, the high tumor load caused the poor prognosis. ConclusionThe solid tumors may present with hematologic manifestations which is similar to the symptoms of MPNs; it belongs to the para-neoplastic phenomenon and may be an independent poor prognostic factors.