预存式自体输血在Rh(D)阴性患者心外手术中的应用  

Application of predeposit autologous blood transfusion in patients with Rh(D) negative blood type during selective cardiac surgery

作　　者：阿迪力江.喀日 努尔比亚.阿布都热西提 木拉提.阿布都热合曼 艾斯卡尔.沙比提 王江[3] 

机构地区：[1]新疆医科大学第一附属医院心脏外科,新疆乌鲁木齐830011 [2]喀什地区第一人民医院检验科,新疆喀什844000 [3]新疆医科大学第一附属医院麻醉科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2009年第4期478-480,共3页Journal of Xinjiang Medical University

摘　　要：目的:观察预存式自体输血在Rh(D)阴性血型患者心外手术中的临床效果及其临床应用。方法:对13例Rh(D)阴性行心外手术患者进行预存式自体输血,准备自体储血之日起嘱患者每8小时口服多糖铁150mg,同时加强饮食营养,采血同时按采血量的3倍输注晶、胶体液体(晶、胶体液体量比例为2∶1),术前分次采集自体血400～800ml,检查患者采血前后及输血前后各项血液指标。结果:所有手术均顺利结束,患者术中仅有2例分别输异体血浆580ml、300ml,其余病例均未输注异体血。采血前后及输血前后红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(Hct)、血小板计数(PLT)、凝血酶原时间(PT)值,经统计分析差异均无统计学意义(P>0.05)。结论:预存式自体输血在提高安全的同时,可有效解决心外手术Rh(D)阴性患者血源不足的问题,有明显临床推广价值。Objective： To evaluate the clinical value and effect of predeposit autologous blood transfusion in cardiac surgery of patients with Rh（D） negative blood type. Methods： Thirteen cases with Rh（D） negative blood type underwent selective cardiac surgery were selected to carry on preoperative autologous blood transfusion, 400-800 ml blood were taken out from the patients before operation based on estimated blood loss. The patients took ferrosi succinatis 150 mg every 8 hour from the day of deciding autologous blood transfusion to the day of surgery operation. Three times of solution to the blood was simultaneously infused （crystalloid solution to colloid solution was 2 ： 1）. Blood components were monitored before and after blood sampling. Results： Two cases received allogenic blood transfusion because of major blood loss during operation. Others did not receive allogenic blood transfusion. There was no significant difference observed in hemological indexes including red blood cells （RBC）, hematocrit （HCT）, hemoglobin （Hb）, platelet （PLT） and prothrombin time （PT） before blood collection, after blood collection and after transfusion. Conclusion： Predeposit autologous blood transfusion is an effective method to solve the shortage of rare blood type for patients with Rh（D） negative blood type during selective cardiac surgery.

关 键 词：心外手术 预存式自体输血 RH(D)阴性血型 

分 类 号：R654[医药卫生—外科学]