术中出血自体回输在外科手术中的应用研究  

The clinical application of intraoperative autologous blood transfusion in surgical operation

作　　者：张春雷[1] 朱斌[2] 陆启兵[2] 周成学[1] 徐玉清[2] 张年[2] 

机构地区：[1]江苏省沭阳县中医院骨科及南京医科大学附属南京第一医院骨科分中心,223600 [2]江苏省沭阳县中医院胸外科,普外科,麻醉科,223600

出　　处：《齐齐哈尔医学院学报》2007年第21期2563-2566,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨术中出血自体回输在外科手术中应用的安全性、效果及所发挥的作用。方法自2006年6～12月．通过应用国产自体-2000型血液回收机（北京京精医疗设备公司）在外科手术中进行自体血回输。对45例病例预先随机分为试验组（A组）和对照组（B组）：A组30例为采用术中出血自体回输的患者；B组15例为完全输异体库存血的患者。并对患者术前、术后24小时进行血常规、凝血功能及血电解质检验，对部分回收血洗涤前、后分别行血细胞形态观察。结果1）在试验组中平均每例回收切口内失血（2863±1514）ml，经洗涤处理后平均每例有（1009±560）ml（占35％）的浓缩血细胞回输给患者，占总输血量的46％。但是仍然有83％的患者需及时补充异体血；2）切口内回收血洗涤后在光镜下观察，大部分血细胞形态完整、清晰、结构正常，大多数细胞碎片已经被清洗掉。此外，我们认为洗涤不会使白细胞产生空泡现象；3）采用自体血液回输后，血Ca^2＋、K^＋均较术前有减少，血小板也减少，差异均有非常显著性意义（P〈0．01）。结论应用术中出血自体回输是安全有效的，值得在临床推广应用，但是不能对其过分依赖。Objective To study the safety and efficacy of intraoperative autologous blood transfusion in surgery. Methods From July 2006 to December 2006, intraoperative autologous blood transfusion was performed during surgical operation, using ZITI-2000 Autologous Blood Recovery System. 45 patients was divided randomly into two groups of therapy and control. 30 patients was set in A, which was the group of intraoperative autologous blood transfusion and 15 patients was set in B, which was the control group. Routine, plasmic electrolyte and coagulative function were examined for the blood samples taken before operation and 24 hours after operation. Some collected blood samples were examined by light microscope. Results ①At group A mean2863±1514 ml lost blood was collected from each patient and got1009± 560 ml （occupied 35,% ）concentrated blood cell after processed by ZITI-2000 Autologous Blood Recovery System in orthopedic surgery. It occupied forty-six percent of total amount of blood infusion during operation. But eighty--three percent of patients need infuse timely banked blood during operation.②Part of the collected blood samples after processed were examined by light microscope. Under the light microscope the shape of most of blood cell was complete, clear and normal, we think the process of water did not result in the bubble in WBC. ③After intraoperative autologous blood transfusion, Ca^2＋ and K^＋ , especial PLT in blood became lower than before （P 〈 0.01）. Conclusions Intraoperative autologous blood transfusion is a safe and effective way, which is worth applying and generalizing at clinic . But we should not depend on it excessively.

关 键 词：血液回收 自体输血 外科手术 

分 类 号：R655[医药卫生—外科学]