回输腹腔引流自体血在闭合性脾损伤非手术治疗中的应用研究  

Autologous transfusion of drained blood from abdomen for conservative treatment of blunt trauma ofspleen

作　　者：曹荣格[1] 夏洪海[1] 曹斌[1] 卢华东[1] 汪迎[1] 魏焱[1] 

机构地区：[1]安徽省立医院急诊外科,合肥230001

出　　处：《中华急诊医学杂志》2013年第1期65-68,共4页Chinese Journal of Emergency Medicine

摘　　要：目的探讨回输腹腔穿刺引流自体血在闭合性脾损伤非手术治疗中的安全性与可行性。方法对2008年1月至2011年12月安徽省立医院急诊外科94例闭合性脾损伤患者进行综合评估，将其中符合非手术治疗指征并且具有输血指征的44例单纯性脾损伤患者随机（随机数字法）分为治疗组与对照组，观察两组间年龄、性别、创伤评分、损伤分级、腹腔引流血液有核细胞计数、淀粉酶、腹腔引流血液量、输血量及损伤至输血间隔时间有无显著差异，然后治疗组回输腹腔引流自体血，对照组输入异体红细胞，比较两组患者输血前后24h以及治疗后在血液动力学、血液成分及凝血指标等方面的差异。结果两组患者输血后血液动力学指标及贫血指标均显著改善；两组患者输血后各项生理指标变化差异无统计学意义。结论伤情评估及腹腔穿刺引流血检验后，回输腹腔穿刺引流自体血可用于闭合性脾损伤非手术治疗，与输入异体红细胞同样安全有效。Objective To study the safety and feasibility of auto-transfusion of blood drained from patients own abdomen in patients with blunt trauma of spleen as conservative treatment. Methods From January 1, 2008 to December 31, 2010, 94 patients were diagnosed to be blunt trauma of spleen. After careful assessment and series lab tests, 44 patients were eligible to be non-operative treated. They were randomly （random number） into two groups in equal number （n = 22）. The patients of auto-transfusion group were transfused the blood drained from patients own abdomen, and the control group was transfused red blood cells from donors. The comparison of demographics, ISS （injury severity scores ）, AAST （American Association for the Surgery of Trauma） and lab findings between two groups before and after transfusion with t test and chi-square test. Then paired-samples t test was used to analyze the hemodynamics, blood components and blood clotting indexes of two groups before and after blood transfusion. Meanwhile t test was done as well to compare the differences in the above variables between two groups after transfusion. SPSS 10.0 version was used to analyze the collected data. Results There were no significant differences in demographics and physical condition between two groups. After blood transfusion, the hemodynamics and anemia of two groups were significantly improved, and there were no differences in the changes of the above variables between two groups. Conclusions Blood drained from patient own abdomen can be auto-transfused in patients with blunt trauma of spleen treated non-operatively as safe and efficient as transfusion of blood from donors. This study proves the autologous transfusionto to be an easy,feasible and economic measures in urgent situation as expected.

关 键 词：自体血回输 脾脏闭合性损伤 腹腔穿刺引流 非手术治疗 

分 类 号：R657[医药卫生—外科学]