成人心脏外科手术术前贫血干预研究进展*

doi:10.3969/j.issn.1671-2587.2025.06.020

临床输血与检验 ›› 2025, Vol. 27 ›› Issue (6): 867-876.DOI: 10.3969/j.issn.1671-2587.2025.06.020

成人心脏外科手术术前贫血干预研究进展^*

陈宇业¹, 单迦晨¹, 高洁¹, 高原², 石佳¹, 纪宏文^1,3

¹中国医学科学院阜外医院麻醉中心,北京 100037;
²中国医学科学院阜外医院输血科,北京 100037;
³中国医学科学院阜外医院深圳医院,广东深圳 518057

收稿日期:2025-06-12 出版日期:2025-12-20 发布日期:2025-12-24
通讯作者: 纪宏文,主要从事心血管手术麻醉与患者血液管理方面研究,E-mail：13701229553@163.com。
作者简介:陈宇业,主要从事患者血液管理方面研究,E-mail：chenyuye@fuwai.com。
基金资助:
^*本课题受阜外医院院内基金（No.2024-AI29）资助

Progress in Preoperative Anemia Intervention Research for Adult Cardiac Surgery

CHEN Yuye¹, SHAN Jiachen¹, GAO Jie¹, GAO Yuan², SHI Jia¹, JI Hongwen^1,3

¹Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037;
²Department of Blood Transfusion, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037;
³Chinese Academy of Medical Sciences Fuwai Hospital Shenzhen Hospital, Guangdong 518057

Received:2025-06-12 Online:2025-12-20 Published:2025-12-24

摘要/Abstract

摘要： 术前贫血在成人心脏外科手术患者中发生率可达10%~30%,与术后发生的多种不良结局相关。有研究证实,实施术前针对性贫血管理可有效降低患者术后发生感染、器官功能损伤及死亡的风险。目前临床实践中的干预策略呈现多元化特征,但这些措施的有效性与安全性尚有一定争议。故本文系统梳理术前贫血的病理生理机制,综述铁补充策略、促红细胞生成素应用策略、维生素B₁₂与叶酸补充策略等常见干预措施的有效性及局限性,介绍几种新型贫血治疗药物,并对涵盖上述措施的综合性患者血液管理进行概述,以期为个性化术前贫血临床诊疗及研究提供参考。

关键词: 心脏外科手术, 术前贫血, 铁剂, 促红细胞生成素, 患者血液管理

Abstract: Preoperative anemia occurs in 10% to 30% of adult patients undergoing cardiac surgery, leading to a range of adverse postoperative outcomes. Evidence suggests that implementing targeted management strategies for preoperative anemia can effectively reduce the risk of complications, including postoperative infections, organ dysfunction, and mortality. Current clinical practice presents a diverse array of intervention strategies; however, their efficacy and safety remain to be subjects of ongoing debate. This article systematically reviews the pathophysiological mechanisms underlying preoperative anemia and summarizes the effectiveness and limitations of common interventions such as iron supplementation, erythropoietin administration, and protocols for vitamin B₁₂ and folic acid supplementation, Additionally, it introduces several novel therapeutic approaches for anemia, and provides an overview of comprehensive Patient Blood Management (PBM). Our aim is to offer a reference for personalized clinical management and further research on preoperative anemia.

Key words: Cardiac surgery, Preoperative anemia, Iron supplemen, Erythropoietin, Patient blood management

中图分类号:

R654.2

陈宇业, 单迦晨, 高洁, 高原, 石佳, 纪宏文. 成人心脏外科手术术前贫血干预研究进展^*[J]. 临床输血与检验, 2025, 27(6): 867-876.

CHEN Yuye, SHAN Jiachen, GAO Jie, GAO Yuan, SHI Jia, JI Hongwen. Progress in Preoperative Anemia Intervention Research for Adult Cardiac Surgery[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2025, 27(6): 867-876.

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成人心脏外科手术术前贫血干预研究进展^*

Progress in Preoperative Anemia Intervention Research for Adult Cardiac Surgery

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