自体血液回收机在肾癌伴腔静脉瘤栓手术中的应用  

Application of Intraoperative Autologous Blood Salvage on Radical Nephrectomy for Renal Carcinoma with Inferior Vena Cava Tumor Thrombus

作　　者：李忠[1] 张明礼[1] 周利群[1] 宋迺庆[1] 杜迎莉[1] 

机构地区：[1]北京大学附属第一医院,北京100034

出　　处：《医疗卫生装备》2009年第4期69-71,共3页Chinese Medical Equipment Journal

摘　　要：目的:评价自体血液回收机在肾癌伴腔静脉瘤栓手术中的应用及肿瘤细胞血行播散的风险性。方法:1999年6月～2005年10月对术中出血量超过1000ml的19例肾癌伴腔静脉瘤栓术中应用自体血液回收技术,分析并比较手术前后血常规及生化指标,评价血液回收机的节约用血效果及术后远期随访情况。结果:术中血液回收全部成功,术后第一天和1周时红细胞计数、血红蛋白水平、红细胞压积均低于术前,而血小板计数虽然在术后第1天低于术前,但在术后1周恢复至术前水平。术后肝、肾功能指标没有明显改变。平均每例回收浓缩红细胞1765ml(300～6000ml),平均每例输库血2247ml(0～8000ml)。围手术期死亡率10.5%(2/19),术后肿瘤远处转移率35.3%(6/17)。结论:肾癌腔静脉瘤栓术中应用自体血液回收对临床重要指标没有明显影响,不增加肾癌复发及转移的危险。Objective To evaluate the application and risk of hematogenous tumor dissemination of intraoperative autologous blood salvage on radical nephrectomy for renal carcinoma with inferior vena cava tumor thrombus.Methods Between July 1999 and October 2005, 19 patients with renal cell carcinoma invading inferior vena cava were used by the intraoperative autologous blood salvage. Preoperative and postoperative clinical data were analyzed and compared. The blood sparing effect and follow-up were evaluated. Results The intraoperative autologous blood salvage of all cases was successful. The levels of HCT, Hb and RBC on the 1st and 7th postoperative day were significantly lower than preoperative day. Although the level of PLT decreased on the 1st postoperative day, it recovered on the 7th day. The markers of liver and renal function did not change during treat time. Packed red blood cells were collected during surgery with a mean value of 1 765 ml（300-6 000 ml） per patient . The average amount of allogenic transfusion per patient was 2 247ml（0-8000 ml）. The perioperative mortality rate was 10.5%（2/19）. The postoperative metastasis rate was 35.3%（6/17）. No difference was found in the prognosis between two groups. Conclusion The intraoperative autologous blood salvage does not markedly change the clinic test data and not increase the recurrence and metastasis of renal cell carcinoma.

关 键 词：自体输血 肾癌 瘤栓 

分 类 号：R737.11[医药卫生—肿瘤]