术中自体血回输在脊柱快速康复外科手术中的应用  

Application of the intraoperative autotransfusion in spinal rapid rehabilitation surgery

作　　者：周玲[1] 谢言虎[1] 秦红[1] 柴小青[1] 

机构地区：[1]安徽医科大学附属省立医院麻醉科,安徽合肥230001

出　　处：《蚌埠医学院学报》2015年第6期734-737,共4页Journal of Bengbu Medical College

摘　　要：目的：观察术中自体血回输技术对脊柱外科患者炎性反应、凝血功能及其他并发症的影响。方法：选择择期预计出血量超过600ml，全麻下拟行脊柱手术的患者60例，采用随机数字表法均分为自体血液回输组（A组）和异体输血组（B组）。记录2组患者自体或异体输血前、输血后1h（T2）、24h（T3）、48h（T4）、72h（T5）动脉血气分析和凝血功能，并采用放射免疫法测定白细胞介素（IL）-6和IL-10。观察术后感染、切口愈合情况和住院时间。结果：A组自体血液回输后T2～T5时点IL-6水平均明显低于B组（P〈0．01），而IL-10均低于B组（P〈0．01）；2组输血后不同时点血红蛋白和凝血功能差异均无统计学意义（P〉0．05）。A组患者术后无任何相关输血并发症的发生，切口愈合良好，手术后住院时间较B组明显缩短（P〈0．01）。结论：脊柱手术中使用自体血回输技术，可明显减轻IL-6和IL-10等炎症因子水平的改变，减少患者手术后并发症，达到快速康复的目的。Objective：To observe the effects of intraoperative autotransfusion on the inflammatory reaction, coagulation function and other complications of spine surgery patients. Methods： Sixty spine surgery patients, whose haemorrhage amount was expected to more than 600 ml, were randomly divided into the autotransfusion group（ group A） and allogeneic transfusion group （group B） using a random number table（30 cases in each group）. Arterial blood gas analysis, coagulation function and the levels of interleukin-6 and -10 （IL-6 and -10） detected by radioimmunoassay in two groups were recorded before transfusion, after 1 h（ T2 ） ,24 h （T3） ,48 h （T4 ） and 72 h （T5 ） of transfusion. The postoperative infection, wound healing and hospitalization days in two groups were observed after operation. Results：The levels of IL-6 and IL-10 in group A at T2 to T5 were significantly lower than those in group B （P 〈 0.01 ）. The differences of Hemoglobin and coagulation function after transfusion between two groups were not statistically significant（ P 〉 0.05 ）. Compared with group B, no postoperative transfusion complication, good wound healing and short hospitalization days were found in group A （P 〈 0. 01 ）. Conclusions： The intraoperative autotransfusion can obviously reduce the levels of IL-6 and IL-10 and postoperative complication, and promote rapid recovery in spine surgery patients.

关 键 词：自体血液回输 脊柱/外科手术 快速康复 

分 类 号：R457.1[医药卫生—治疗学]