人工膝关节表面置换术后自体引流血回输的效用  

The Efficacy of Allogeneic Blood Transfusion after Total Knee Replacement

作　　者：黄志峰[1] 翁习生[1] 邱贵兴[1] 金今[1] 林进[1] 赵庆[1] 杨新宇[1] 

机构地区：[1]中国医学科学院北京协和医院骨科,北京100730

出　　处：《实用骨科杂志》2007年第7期385-387,共3页Journal of Practical Orthopaedics

摘　　要：目的人工膝关节表面置换术后常常需要输血治疗,输异体血的弊端在于可能导致传染性疾病的传播,配型不合导致输血反应或免疫调节反应。另外异体血血源紧张,费用昂贵,因此临床上应尽量减少异体输血。关于自体血回输器的应用文献报道效果不一,本文旨在探讨人工膝关节表面置换术后自体引流血回输的效用。方法使用回顾性质量评估设计,我们比较了136例择期行人工膝关节表面置换的病人和历史上同样行膝关节表面置换的116例病人。研究组使用了Consta VacTMCBC自体血回输器,伤口血液经回输器过滤后回输。对照组的引流血液被弃置。根据病人的临床表现和血红蛋白水平决定异体血的回输量,使术后血红蛋白水平维持在10 g/dL以上。比较两组术前及出院时的血红蛋白水平和输异体血的量和比例。结果两组间术前和出院时的血红蛋白水平没有统计学差异。输异体血的比例在单膝置换时,未回输组为27.3%,回输组为14.3%。在双膝置换时,未回输组为85.2%,回输组为45.1%。结论使用自体血回输器可以减少人工膝关节表面置换术后输异体血的比例和输血量。Objective To evaluate allogeneic blood transfusion after total knee replacement. Methods Using a retrospective observational quality assessment design, we compared 136 patients scheduled for TKA with a historic group of 116 patients. In the study group the Consta Vac^TM CBCⅡ autotransfusion system was used. The shed blood was returned either when 500 mL were collected or at most 6 hours after surgery. Compared were the preoperative, postoperative and discharge hemoglobin, as well as the number of allogeneic blood transfusions. Results There were no statistical differences between preoperative,postoperative, and discharge hemoglobin levels. Autologus transfusion reduced the number of patients receiving allogeneic blood transfusion overall from 27.3%to 14.1% in unilateral TKA and from 85. 2% to 45. 1% in bilateral TKA. Conclusion We eonclude that the device reduces allogeneic blood transfusion in TKA, especially for bilateral replacement patients.

关 键 词：全膝关节置换 输血 自体血回输 效用 

分 类 号：R318.17[医药卫生—生物医学工程]