改良自体血储存联合洗涤式自体引流血回输  

Application of the Modified Predeposited Autologous Transfusion Combined with Reinfusion of Postoperative Salvaged Blood in Total Knee Arthroplasty

作　　者：沈文生[1] 任志伟[1] 楼洁[1] 邵瑾[1] 李丹升[1] 

机构地区：[1]浙江省绍兴市中医院麻醉科,绍兴312000

出　　处：《中国中西医结合外科杂志》2015年第1期29-32,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：2013年绍兴市公益性技术应用研究计划(2013B70086)

摘　　要：目的:探讨改良自体血储存联合Ortho PAT术后引流血回输在单侧全膝关节成形术中的应用效果和安全性。方法:纳入全膝关节置换术患者50例,随机分改良自体血储存联合Ortho PAT术后引流血回输组25例(A组),常规异源性输血组25例为对照组(C组);记录两组麻醉前即刻、术中、自体血回输前10 min、回输后15 min、术后6 h及24 h各时间点血色素水平和凝血功能;记录24 h引流血总量,异体血输入量和异体输血率。结果:A组各时间点Hb、Hct与术前3 d值比较(PHb=0.832>0.05,PHct=0.785>0.05),A组与C组术前、术中、术后24 h比较(PT1=0.785>0.05,PT2=0.745>0.05,PT6=0.851>0.05),A组输异体血比率极低,A组与C组异体输血量和异体输血率有显著性差异(P=0.001<0.05)。结论:改良自体血储存联合Ortho PAT术后引流血回输在单侧膝关节成形术应用节血效果确切,不良反应发生率低,输异体血比率极低。Objective To evaluate the effects and safety of improved predeposit autologous transfusion com-bined with reinfusion of postoperative salvaged blood in total knee arthroplasty.Methods50 patients withsurgery of total knee arthroplasty were randomly divided into two groups： group A, the improved predeposit autol-ogous transfusion combined with reinfusion of postoperative salvaged blood（n=25）, group C, the allogenic bloodtransfusion（n=25）. The hemoglobin concentration and blood coagulation were recorded at pre-anesthesia, duringoperation, 10 minutes before predeposit autologous transfusion, 15 minutes after predeposit autologous transfu-sion, 6 hours and 24 hours post-operation. The hemoglobin concentration and blood coagulation in group A wererecorded at 3 days before surgery, 10 minutes before and after extraction of autologous blood. Volume of blooddrainage in 24 hours post-operation, allograft blood transfusion and allogeneic blood transfusion rate were alsorecorded.ResultsCompared with 3 days pre-operation, there were no statistical differences in Hb and Hctin group A at each time point（PHb=0.8320.05,PHct=0.7850.05）. The Hb and Hct were no statistical differenc-es between group A and group C at before, during and 24 hours after operation（PT1=0.7850.05,PT2=0.7450.05,PT6=0.8510.05）. Compared with group C, the volume of allograft blood transfusion and allogeneic bloodtransfusion rate were significantly lower than that of group C（P=0.0010.05）.ConclusionImproved predepos-it autologous transfusion combined with reinfusion of postoperative salvaged blood in total knee arthroplastycould reduce the waste of autologous blood and the amount of allogenic blood given.

关 键 词：OrthoPAT 膝关节成行术 自体储血 

分 类 号：R457.1[医药卫生—治疗学]