体外循环心脏手术不输库血80例临床分析  

Clinical Analysis of 80 Cases with no Allogeneic Transfusion in Cardiac Surgery under Extracorporeal Circulation

作　　者：何建超[1] 曹光琼[1] 

机构地区：[1]昆明医学院第一附属医院心脏外科,云南昆明650032

出　　处：《昆明医学院学报》2007年第2期59-61,共3页Journal of Kunming Medical College

摘　　要：目的采用综合措施进行血液保护,探讨体外循环心内直视手术不用库血,避免输血性感染性疾病的发生.方法①术前经腔静脉放血,按10-18 mL/kg,同时经动脉供血管输注无血预充液,维持体液平衡,中度稀释血液（Hct 0.20-0.25）体外循环结束,根据动静脉压及尿量全部回输剩余机血,术后加强利尿,浓缩血液;②在预充液中均加入抑肽酶,剂量6×10^6K IU/kg;③外科手术认真止血.结果80例直视心脏手术患者,均未达到输血标准,围术期未输库血.术后48 h总引流量平均（296±58.21）mL,患者出院前3 d复查Hb均大于115 g/L,Hct大于0.40,全组病例顺利康复.结论直视心脏手术,采用综合血液保护措施,不输库血,避免输血性感染性疾病的发生.Objective The comprehensive blood conservation was used in intracardiac surgery under extracorporeal circulation to protect patients from infectious diseases transmitted by allogeneic transfusion. Methods （ 1 ） Blood was collected from venous （ 10 mL/kg） and pumped solution through aortic artery. Moderate hemodilution was used. After cardiopulmonary bypass, the blood was all autotransfused. （2） Aprotinin was used （6 × 10^6 KIU/kg）. （3） Bleeding was carefully treated. Results The eighty cases were not qualified for allogeneic transfusion. The average of drainage volume was （296 ± 58.21 ） mL 48 hours after the operation. Three days before the patients were discharged, exanimation showed that hemoglobin was more than 115 g/L and hematocrit more than 0. 40. CONClUSiONS The ways of blood conservation used on the patients with cardiac surgery under extracorporeal circulation can avoid infectious diseases caused by allogeneic transfusion.

关 键 词：体外循环 血液保护 输血 

分 类 号：R645.2[医药卫生—外科学] R475.1[医药卫生—临床医学]