回收式自体输血在肝硬化肝移植手术中的临床应用  

Application of autologous transfusion in liver transplantation for hepatocirrhosis

作　　者：陈波[1] 葛春红[1] 林艳[1] 刘银[1] 周晔[1] 唐晓峰[1] 

机构地区：[1]第二军医大学附属二院输血科,上海200003

出　　处：《临床血液学杂志（输血与检验）》2013年第1期83-84,87,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：上海市公共卫生重点学科建设计划资助项目(No:12GWZX0202)

摘　　要：目的:探讨回收式自体输血在肝硬化肝移植手术中的应用及其安全性。方法:针对实施手术的35例肝硬化患者,采用FCR-3000F型全自动自体血液回收系统,将肝移植术中出血回收,经抗凝、过滤、离心、清洗后,将得到的红细胞悬液立即回输给患者;统计术中自体及异体的输血量,输血前后电解质、凝血功能的变化,以及输血相关不良反应的情况。结果:35例肝硬化患者中3例(8.6%)未输注异体血,术中红细胞悬液平均输入量(9 800±5 400)ml,其中自体输血量(5 850±5 000)ml(56.16%);输血后APTT、PT、TT及FB较输血前明显延长,差异有统计学意义(P<0.05);患者在回输自体血过程中均未出现发热、脂肪栓塞及全身感染症状。结论:临床上在肝硬化肝移植术中使用回收式自体血液技术能够避免或减少输注异体血,对于保证手术用血量和患者安全是一种安全有效地手段。Objective：To investigate the application and safety of autologous blood transfusion on hepatocirrhosis patients who received liver transplantation. Method：Autologous blood was collected during liver transplantation surgery from 35 patients suffering from hepatocirrhosis with FCR-3000 automatic blood collecting system.Anticoagulantion,filter,centrifugation and washing was performed to generate red blood cells suspension which would be transfused autologously subsequently.We collected the quantity of blood allotransfused and autotransfused.Pre-and postoperation blood electrolytes and coagulation were examined and transfusion related adverse effect was monitored. Result：Three from 35 patients（8.6%） did not receive allotransfusion.The average quantity of red blood cell suspension transfused was（9800±5400） ml,from which the average autotransfused blood quantity was（5850±5000） ml（56.16%）.The postoperational APTT,PT,TT and FB were significantly extended（P0.05）.Moreover,adverse effects including fever,fat embolism and general infection were not observed. Conclusion：The application of autologous blood transfusion in liver transplantation performed on cirrhosis patients would contribute to avoid or at least reduce allotranfusion,hence ensuring the blood quantity and patient safety.

关 键 词：自体输血 血液回收 输血安全 

分 类 号：R457.1[医药卫生—治疗学]