术中回输自体血红细胞对凝血功能的影响  

Changes of coagulate function after reinfusion of autologous scavenged red blood cells

作　　者：沈伯雄[1] 罗伟[1] 周为民[1] 汪爱民[1] 黄雪花[1] 梁志泳[1] 金雯霞[1] 

机构地区：[1]上海第二医科大学宝钢医院麻醉科,上海201900

出　　处：《上海第二医科大学学报》2004年第11期939-941,共3页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的分析术中回输自体血红细胞对凝血功能的影响 ,提高临床应用的安全性。方法 12 5例采用自体血回输技术的病人 ,根据总出血量和回输血量分为 3组 ,分别比较手术前、回输前后血Hb、Hct和凝血功能的变化。结果A组 (回输血 <80 0mL)回输后Hb和Hct比回输前提高 ,回输前FDP比手术前增加 (P <0 .0 5 ) ,回输后又接近正常。B组 (回输血 80 0～ 10 0 0mL)回输后除Hb较回输前上升外 ,PT、APTT延长 ,FIB降低 ,但组内比较无显著差异 (P >0 .0 5 )。C组 (回输血 >10 0 0mL)手术前、回输前后的Hb、Hct低于正常值 ,PT、APTT延长 ,回输后凝血功能指标较回输前减退更明显 (P <0 .0 5 ) ,但回输后的Hb、Hct较术前有明显改善 (P <0 .0 5 )。结论术中回输自体血有利于维持红细胞携氧能力 。Objective To evaluate changes of coagulate function after reinfusion of autologous scavenged red blood cells (ASRBC). Methods One hundred twenty-five patients with reinfusion ASRBC were divided into three groups depending upon total blood lose and volume of reinfusion ASRBC. Hb and Hct were monitored before operation, before and after reinfusion. Results In group A, ASRBC<800 mL, Hb and Hct was elevate after reinfusion compared with before reinfusion(P<0.05). FDP was increased before reinfusion compared with before operation (P<0.05),and return normal after reinfusion. In group B, ASRBC 800～1 000 mL, PT,APTT and FIB were abnormal before and after reinfusion while Hb increased after reinfusion. In group C, ASRBC>800～1 000 mL, Hb,Hct were abnormal and PT, APTT prolonged at before operation, before and after reinfusion,but Hb, Hct were improved significantly after reinfusion compared with before reinfusion (P<0.05). Conclusion Reinfusion of ASRBC can maintain the ability of oxygen carrying of red blood cells, but coagulation function should be monitored at the same time.

关 键 词：术中 回输自体血 红细胞 凝血功能 安全性 

分 类 号：R605[医药卫生—外科学]