自体血回输对骨科手术患者组织氧代谢的影响  

Effect of blood salvage on oxygenation in patients undergoing orthopedic surgeries

作　　者：李建华[1] 李斌[1] 胡惠英[1] 程磊[1] 吴坛光[1] 

机构地区：[1]解放军第161中心医院麻醉科,武汉市430010

出　　处：《临床麻醉学杂志》2013年第4期322-324,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察自体血回输对骨科手术患者组织氧代谢的影响。方法择期行骨科手术患者40例,随机均分为两组。回输组术中应用血细胞回输仪进行血液收集、回输,对照组不行血液回收。分别于术前(T1)、术毕(T2)及术后24h(T3)行动、静脉血气分析。记录患者术中回收血量、异体浓缩红细胞量及异体血浆量。监测红细胞变形能力(IF)及红细胞2,3-二磷酸甘油酸(2,3-DPG)含量。结果手术开始至术后24h内回输组输注异体浓缩红细胞量及血浆量明显少于对照组(P<0.05)。T2时回输组PaO2、PO2、SO2、CaO2、CvO2以及2,3-DPG均明显高于对照组(P<0.05)。T2、T3时回输组氧摄取率(ERO2)以及动脉血乳酸(aLac)、静脉血乳酸(vLac)、IF值均明显低于对照组(P<0.05)。结论骨科手术患者应用自体血回输技术能维持有效循环,明显改善血液氧合和能量代谢。Objective To evaluate the effect of blood salvage on oxygenation in patients undergoing orthopedic surgery. Methods Forty patients for selective orthopedic surgery, were randomly divided into two groups（n= 20 each）. Salvage group received autologous blood transfusion. The blood samples were collected before operation（T1 ）, immediately after operation （T2） and 24 h after operation（T3 ）, for the measurement of PaO2, PvO2, SaO2, SvO2, CaO2, CvO2, ERO2 and blood lactate concentration. The volume of blood recovery, erythrocyte suspension and plasma were counted. Erythrocyte filterability index（IF） and content of erythtoeyte 2,3-diphosphoglyeeric acid （2,3-DPG） were measured and compared after operation. Results The volume of erythrocyte suspension and plasma were significantly higher in control group than that of the salvage group （P~ 0.05）. The PaO2,PvO2, SvO2, CaO2, CvO2, and 2, 3-DPG were significantly higher in salvage group than in control group at 1＂2 （P%0.05）. The blood lactate concentration, ERO2 and IF were significant lower in salvage group than in control group at T2 and T3 （P〈0.05）. Conclusion Autologous blood transfusion can effectively maintain hemodynamic stability and has a great effect on the oxygen supply and demand and metabolism of energy.

关 键 词：骨科手术 自体血回输 乳酸 组织氧代谢 

分 类 号：R687[医药卫生—骨科学]