食管贲门癌肺癌外科治疗采用等容血液稀释自身输血临床研究  

Clinical study on the surgical treatment of esophagus cardia and lung carcinoma autotransfusion of isovolumable blood dilution

作　　者：张云增 刘军校 冯敬 蒋红林 王彦平 田力军 孙娜 陈慧芹 

机构地区：[1]邢台市肿瘤医院,河北邢台054001

出　　处：《现代保健（医学创新研究）》2006年第03X期7-8,共2页

摘　　要：目的自身输血安全可靠，前者可扩大病人的血容量，后者可减少病人的血液丢失，防止供血途径感染（HIV HAV HBV HCV）。方法临床手术中21例患者采用了等客血液稀释自身输血。术前采患者外周静脉血密闭，室温下贮存，同样输入血浆代用品，患者血液被稀释，手术结束后，将贮存的患者血回输。结果男性15例，女性6例，患者年龄34-74岁，21例中食管贲门癌肺癌20例，回盲部肉瘤1例。每例患者均采用血200ml，稀释液用血浆代用品706代血浆400ml，手术结束后回输无不良反应，手术中患者平稳。患者血液稀释前后及术后二周血流动力学、血生化学、凝血功能、肝肾功能等正常，患者HCT平均值降至28．28％，HB平均值降至92∥L，达到中度血液稀释，血液稀释前相比，患者HB、HCT、RBC显著降低，仍在正常范围内，术后两周HB、HCT、RBC与稀释前比无显著变化。结论急性等客血液稀释自身输血的方法操作简单，安全方便，用于肿瘤患者具有理想、实用、可靠、经济及预后良好的优点，该方法不抑制免疫功能，可以提高生存率，降低复发率，减少患者的用血量。是节约用血，防止输血传播各种病毒的一种好方法，可用于基层边远山区医院病人抢救和治疗及适合家庭贫困患者更理想。Objective Autotransfusion is a safe and reliable method. It can expand the blood volume of the patient and reduce the blood loss, it can prevent infecting by blood tranfusing（HIV HAV HBV HCV）.Methods Autotransfusion of isovolumable blood dilution was used by 21 pa- tients in clinic operation. Before the operation, the peripheral venous blood of the patients was collected and sealed up, preserved in room temperature. The same volume blood substitute was inputed to dilute the patient＇s blood. After the operation, the preserved patient＇s blood was reinputed. Results 15 male cases,6 female cases. The age ranged from 34 - 74 years. Among the 21 cases there were 20 cases of esophagus cardia and lung carcinoma, 1 case ileocecum sarcoma. 200ml peripheral venous blood of 21 cases of the patients was collected and preserved and after that 400ml 706 plasma was inputed to everypatient to dilute blood. After the operation, the 200ml peripheral venous blood was reinputed to everyone. The patients were safe during the operation. During this time, the hemodynamics, the blood bilchemical analysis, the function of blood congulation and the liverrenal function of the patients were normal. The HCT averages of the patients decreased to 28.28%, the HB average decreased to 92g/L, and both of them had been decreased obviously than they were before blood dilution, but they still were normal. The patient＇s blood level of HB HCT RBC two weeks after the operations have no change obviously.Conclusions It is a safe,reliable,scintific and ecinimical method that to use acute isochorcic blood dilute auto transfusion in clinic especially to cancer patients. This method not only doesn＇t inhibit immunologic function but can improve survival rates, reduce recurernce rates, savingblood and avoid infecting diseades also. Especially in badic and remote hospitals, using this method is good for poor patient＇s health.

关 键 词：食管贲门肺癌 外科治疗 等容稀释 自身输血 

分 类 号：R735.1[医药卫生—肿瘤]