输注自体血与库存血对患者术后炎症反应的影响  

The different influence of inflammatory response after transfusion with autologous blood and stored blood

作　　者：崔波[1] 赵平[1] 王超[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳市110000

出　　处：《临床麻醉学杂志》2015年第3期247-249,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨输注自体回输血与保存时间短于2周的库存血对患者术后炎症反应的影响。方法选择择期行腰椎滑脱椎弓根内固定植骨融合术手术,估计出血量多于500ml的骨科患者40例。其中20例患者应用自体血回输装置即为回收血组(A组),20例患者单独输注短于2周的库存血即为库存血组(B组)。检测两组患者Hb、Hct、pH、K+、ATP含量和2,3-二磷酸甘油酸(2,3-DPG)及输血后患者的WBC、C-反应蛋白(CRP)、血沉(ESR)。结果 A组患者的pH值、K+、Hct、ATP、2,3-DPG均明显高于B组(P<0.05);两组术后1、3dWBC,术后1、3、5dCRP、ESR均明显高于术前(P<0.05);术后1、3、5dB组的CRP、ESR均明显高于A组(P<0.05)。结论自体血的质量明显优于库存血,输注自体血的患者术后CRP、ESR明显低于输注库存血的患者,提示输注自体血的炎症反应发生率较库存血低。Objective To investigate the different influence of inflammatory response after transfusion with autologous blood and stored blood.Methods Forty orthopedic patients,undergoing selective lumbar spine pedicle internal fixation and interbody fusion surgery,whose estimated intraoperative bleeding volume was more than 500 ml were enrolled.Twenty cases with autologous blood transfusion device（group A）,and 20 patients infused stored blood is the stored blood group（group B）.Hb,Hct,pH,K^＋,ATP,2,3-diphosphoylyceric acid（DPG）,white blood cells and C-reactive protein（CRP）and blood sedimentation after infusion were detected in all patients.Results The values of pH,ATP,2,3-DPG,Hb and Hct in group A were higher than those in group B and the difference was statistically significant（P〈0.05）;There were no significant differences in WBC,CRP,ESR before surgery and the changes of postoperative WBC between the two groups,while the CRP and ESR of group A were significantly lower than those of group B（P〈0.05）.Conclusion Autologous blood is obviously better than stored blood with lower postoperative CRP and ESR,which suggests that the inflammatory response is lower after autologous blood transfusion.

关 键 词：自体血 库存血 2 3-二磷酸甘油酸 C-反应蛋白 血沉 

分 类 号：R614[医药卫生—麻醉学] R457.1[医药卫生—外科学]