吸引负压对术中回收血液质量的影响  

The effects of suction pressure on the quality of salvaged blood

作　　者：梁辉[1] 王德祥[1] 赵岩[1] 王保国[2] 韩如泉[1] 

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,北京100050 [2]北京三博复兴脑科医院

出　　处：《中国输血杂志》2010年第1期31-34,共4页Chinese Journal of Blood Transfusion

摘　　要：目的考察不同吸引负压对术中回收血液质量的影响。方法30例择期颅脑手术患者,随机等分为2组,自手术开始分别用0.02 Mpa(0.02 Mpa组)及0.04 Mpa(0.04 Mpa组)的负压收集术野出血,2组均用FreseniusCATS型血液回收机对收集血进行离心清洗。检验收集血及清洗后回收血的血细胞比容、溶血率及K+浓度,计算收集血中红细胞的回收率,检测术中动脉血及回收血的最大红细胞变形指数。结果0.04 Mpa组收集血的溶血率及K+浓度均明显高于0.02 Mpa组(P<0.01),清洗后2组回收血的平均溶血率分别降至(0.17±0.04)%及(0.32±0.08)%,K+浓度也明显下降(P<0.01)。0.04 Mpa组收集血红细胞回收率低于0.02Mpa组(P<0.05)。2组收集血及清洗后回收血的最大红细胞变形指数均明显低于动脉血红细胞(P<0.01),0.04Mpa组回收血的红细胞变形指数相对于动脉血红细胞的下降幅度明显大于0.02 Mpa组(P<0.05)。结论用0.04Mpa的吸引负压收集术中出血,虽然安全性是有保证的,但其回收出血的效率下降,而且可能对回收红细胞的体内功能状态造成不利影响。Objective To evaluate the effects of suction pressure on the quality of salvaged blood. Method Thirty patients scheduled for elective craniotomy were randomly allocated into 2 groups, and a Fresenius C. A. T. S was used to process the collected blood. Two different levels of suction pressure, 0.02 Mpa （0. 02 Mpa group） and 0.04 Mpa （0.04 Mpa group）, were used to collect the shed blood from the surgical field. The hemolysis rate and the concentration of K ＋ of the collected and washed blood were tested（measured）. The capture rates of the collected shed erythrocytes were calculated. The maximum deformation indexes （DI max） of the erythrocytes from arterial blood, suctioned blood and washed blood were also examined. Results Both of the hemolysis rate and the concentration of K ＋ of collected blood and washed blood from 0. 04 Mpa group were significantly higher than 0. 02 Mpa group（ P = 0. 001 and P 〈 0. 001 ）. After being processed by CATS, hemolysis rates of the two groups decreased to 0. 17% ±0. 04% and 0. 32% ±0. 08% respectively. The capture rate of the sucfioned erythrocytes in 0. 04 Mpa group was significantly lower than that of 0. 04 Mpa group （P = 0. 025 ）. In the both two groups, the DI max of the erythrocytes from suctioned blood and washed blood were lower than that of the erythrocytes from arterial blood（P 〈0. 001 ）. Furthermore, the margins of decrease of the DI max of suctioned erythrocytesand washed erythrocytes in 0. 04 Mpa group were significantly higher than those of 0. 02 Mpa group （ P = 0. 003 and 0. 032）. Conclusion It is still safe to collect shed blood using the high suction pressure of 0.04 Mpa. However, high suc- tion pressure reduces the efficacy of blood salvage, and may deteriorate the function of retransfused erythrocytes.

关 键 词：输血/自体 开颅手术 红细胞变形性 

分 类 号：R457.1[医药卫生—治疗学] R651.11[医药卫生—临床医学]