自体血回输技术在心脏瓣膜置换术中的应用研究  

Observation on application of autologous blood transfusion in the heart valve replacement

作　　者：梁友君[1] 林丽珠[1] 范海鸥[1] 邓梅玉[1] 褚立君[1] 杨贵安[1] 

机构地区：[1]广西壮族自治区钦州市第一人民医院麻醉科,535000

出　　处：《中国体外循环杂志》2012年第1期13-15,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的探讨自体血回输在心脏瓣膜置换术中的应用价值。方法对43例择期行心脏瓣膜置换术患者采用京精自体血液回收机3000P型进行洗涤式自体血回输,并对患者术前和术后24小时血红蛋白(Hb)、红细胞比容(Hct)、红细胞计数(RBC)、白细胞计数(WBC)、血小板计数(Plt)、凝血活酶时间(PT)、活化部分凝血酶时间(APTT)、术后24小时引流量进行分析。结果 43例患者所有的回收血经过血液回收机处理后共获得洗涤后浓缩红细胞为36 400 ml。手术前后患者RBC、APTT无明显变化(P>0.05),Hb、Hct低于术前(P<0.05),但也都位于正常参考值范围内,Plt比术前明显降低(P<0.01),WBC较术前明显增高(P<0.01),术后引流量均在可接受的范围内。所有患者在回输血过程中均无明显的不良输血反应。结论回收式自体血液回输可有效减少心脏瓣膜置换术中血液丢失,减少异体血输注量,减少输血费用,避免血液传播疾病及各种输血反应的发生。Objective To investigate the value of autologous blood transfusion in the heart valve replacement. Methods U- sing .ling Jing - 3000P autologous blood recovery system was applied for 43 patients underwent elective valve replacement. Hemoglobin （Hb）, hematocrit （Hct）, the red blood cell count （RBC）, the white blood cell count （WBC）, the platelet count （Pit）, thrombin time （PT） and activated partial thromboplastin time （APTr） were measured preoperatively andat 24 hours postoperatively. Blood loss during the first 24 hours after surgery was also measured. Results The total autologous blood transfusion volume of 43 patients was 36400 ml. No significant change of the RBC and APTT were found in this group. Postoperative Hb and Hct were lower, but they were still within normal reference values. After operation, PIt dicreased significantly and WBC increased obviously. Blood loss was within the acceptable range. No autologous blood transfusion complications occurred in all cases. Conclusion For patients underwent cardiac valve replacement, autologous blood transfusion can effectively reduce blood loss, allogeneic blood transfusion and blood transfusion costs, meanwhile can avoid blood transmitted diseases and all kinds of transfusion reaction.

关 键 词：心脏瓣膜置换术 自体血回输 血液保护 

分 类 号：R654.2[医药卫生—外科学]