脊柱矫形术中血液回收对输血的影响  

Effects of blood salvage on intra-and postoperative transfusion in spinal surgery

作　　者：陈兴芳 招伟贤 陈研生 黎涌 谢健 

机构地区：[1]广州中医药大学第二附属医院麻醉科,广州510120

出　　处：《广东医学》2011年第22期2900-2902,共3页Guangdong Medical Journal

摘　　要：目的观测与评价脊柱矫形术中血液回收对术中及术后输血的影响。方法选择择期后路脊柱矫形手术病例,按照术中是否使用血液回收分为回收组(n=15)和非回收组(n=49),对比两组的手术时间、打钉数量、手术失血及术中术后输血。结果回收组的手术时间、打钉数量、手术失血及术中输液量均明显长于或多于非回收组(P<0.001),但两组术中的循环功能及术中术后Hb、Hct和凝血指标等差异均无统计学意义(P>0.05)。两组术中均无异体输血,但术后均有相似的输血率(回收组20.0%,非回收组16.3%,P>0.05)。结论对打钉数量达6支及术中有失血较多趋势的脊柱手术患者应用血液回收有助于维持循环稳定和减少术中输血,但未实质性减少术后输血。Objective To evaluate the effects of blood salvage on intra- and postoperative transfusion in spine surgery. Methods Patients with elective posterior spinal surgery with pedicle screw fixation, according to usage of intraoperative blood salvage, were divided into salvage （ n = 15 ） and non - salvage （ n = 49 ） groups. Surgical time, pedicle screw number, blood loss during surgery, and transfusions during and after operation were recorded for comparison. Resuits The surgical time, number of pedicle screws, blood loss and fluid infusion during surgery were significantly increased in the salvage group compared with those in non - salvage group （ P 〈 0. 001 ）. There was no significant difference in the circulatory function, Hb, Hct and coagulation parameters intra - and postoperatively between the two groups （ P 〉 0. 05 ）. There was no allogenic blood transfusion during surgery in both groups, also with similar postoperative transfusion rates （ 20. 0% in salvage group and 16.3 % in non - salvage group, P 〉 0.05 ）. Conclusion Intraoperative blood salvage in patients undergoing spinal surgery with six or more pedicle screw fixations can help to maintain stable circulation and reduce blood transfusion during surgery, but does not reduce postoperative transfusion.

关 键 词：脊柱矫形 血液回收 失血 输血 

分 类 号：R730.56[医药卫生—肿瘤]