自体血回输对病人血浆肝素含量的影响  

Effect of autotransfusion on plasma heparin concentrations in surgical patients

作　　者：孙新艳[1] 宋冰冰[1] 王俊科[1] 张晓光[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,沈阳市110001

出　　处：《临床麻醉学杂志》2002年第4期184-185,共2页Journal of Clinical Anesthesiology

摘　　要：目的　观察自体血回输对病人血浆中肝素含量的影响 ,探讨肝素在血液回收时的应用。方法　自体血液回输组 (n =32 )与异体输血组 (n =30 )骨科、脑科择期手术病人 ,男女各半 ,年龄 18～ 48岁 ,术前肝、肾、凝血功能均正常 ,无其他血液系统疾病。自体回输血量及异体输血量均超过 10 0 0ml。采用凝固法测定血浆中肝素含量 ;ACT Ⅱ型测定仪测定血中活化凝血时间 (ACT)。结果肝素含量 :自体血液回输组 ,术前、输血前、输血后 2小时肝素含量分别为 (0 6 5± 0 2 7)、(0 6 8±0 2 0 )和 (0 72± 0 19)U/ml;异体输血组分别为 (0 6 3± 0 2 4)、(0 6 7± 0 2 8)和 (0 6 9± 0 2 0 )U/ml。两组间均无显著差异 (P >0 0 5 )。ACT :自体血回输组三个不同时间分别为 (86 10± 2 0 5 4)、(133 5 0± 2 9 6 5 )和 (95 0 5± 2 9 71)秒 ;异体输血组分别为 (88 42± 18 37)、(131 70± 2 7 36 )和(92 86± 14 35 )秒。两组ACT值输血前均明显长于术前 (P <0 0 5 ) ,术前与输血后 2小时无显著差异 (P >0 0 5 )。结论　自体血液回输组与异体输血组术前、输血前、输血后 2小时肝素含量无显著差异。自体血回输中使用肝素抗凝适量 。Objective To observe the effect of autotransfusion on plasma heparin concentrations in surgical patients.Method Sixty two patients for orthopedic and neurosurgical operations were assigned to autotransfusion group (n=32) and allogenic transfusion group (n=30).The patients had a normal hepatic,renal,and coagulation functions and had no hematopathy.Transfusion volumes in both groups exceeded 1000ml.Heparin concentrations were detected by clotting procedures and ACT was measured with ACT-Ⅱ detector respectively.Results Heparin concentrations in autotransfusion group v 1 allogenic transfusion group were (0.65±0.27)u/ml v 1(0.63±0.24)u/ml before operation,(0.68±0.20)u/ml v 1(0.67±0.28)u/ml before transfusion,(0.72±0.19)u/ml v 1 (0.69±0.20)u/ml two hours after tranfusion.There was no significant defference existed between two groups (P>0.05).At the same three time points,ACT in autotransfusion group v 1 allogenic transfusion group were (86.10±20.54)s v 1(88.42±18.37)s,(133.50±29.65)s v 1 (131.70±27.36)s and (95.05±29.71)s v 1(92.86±14.35)s.ACT before transfusion remarkbly decreased compared with preoperative value in both groups (P<0.05).There was no significant difference in ACT measurements before operation compared with those at two hours after transfusion (P>0.05).Conclusion Heparin concentrations in autotransfusion patients is not defferent from the allogenic transfusion before operation,before transfusion or 2h after transfusion.Using moderate dosage of heparin in autotransfusion may be safe and feasible.

关 键 词：自体血液回输 凝血功能 肝素 活化凝血时间 

分 类 号：R457.1[医药卫生—治疗学]