回收式自体输血对手术患者凝血及免疫功能的影响  

Changes in blood coagulation and T-Lymphocyte subset and natural killer cell after blood salvage and homologous blood transfusion.

作　　者：孙桂珍[1] 迟梅英[1] 贾海燕[1] 魏玉芝[1] 

机构地区：[1]聊城市人民医院,山东聊城252000

出　　处：《山东医药》2006年第20期20-21,共2页Shandong Medical Journal

基　　金：聊城市科技局资助项目(2005-154)

摘　　要：目的探讨回收式自体输血(BS)对机体凝血状态和T淋巴细胞亚群、NK细胞功能的影响。方法选择骨科大手术患者40例,随机分为自体输血组(BS组)和异体输血组(异体组)各20例,术中分别采用BS及输异体血,分别于术前、输血后1 h及输血后24 h测定血常规、APTT、PT、F IB及ACT;流式细胞仪测定输血后第1天、第5天T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+值及NK细胞。结果输血后1 h两组APTT、PT、ACT均延长,F IB和PLT计数均降低(P<0.05),但尚在正常范围内,组间比较无显著性差异(P>0.05)。异体输血组输血后第1天和第5天CD3+、CD4+、CD8+、NK变化显著低于BS组(P<0.01);BS前后上述指标无明显变化(P>0.05)。结论BS对凝血功能的影响与异体输血相似,大量回输时应注意补充凝血因子和血小板;BS对机体细胞免疫功能无明显抑制作用。[Objective] To investigate the changes in blood coagulation and T-Lymphocyte subset and natural killer cell after blood salvage and homologous blood transfusion. [Methods] 40 patients undergoing elective erthopextic surgery were randomly divided into 2 groups： blood salvage group and homologous blood transfusion group. On preoperative, 1 h after blood transfusion and 24 h after blood transfusion, PLT, PT, APTT, FIB and ACT were measured. On the 1st and 5th day after operation measured T-lymphocyte subsets and natural killer ceil＇counts by flow cytometry and account CD4^＋/CD8^＋. [Results] After blood transfusion, APTT, PT, ACT increased significantly, and FIB and PLT decreased in these groups （P 〈 0. 05）, there was no significant difference between the two groups. In The homologous blood transfusion group the number of CD3^＋, CD4^＋, CD4^＋/CD8^＋, NK cell decreased obviously on the 1st and 5th day after operation compared with preoperative （P〈 0. 01）, there were no signifrcant changes in the bood salvage group. [Conclusion] Intraoperative blood salvage and reinfusion induce no significant effects on blood coagulation as compared with allogenic blbod transfusion. Blood salvage influence on immune function is slight.

关 键 词：输血 自体 血液回收 免疫 

分 类 号：R473.6[医药卫生—护理学]