不同血液稀释法联合回收式自体输血在围术期中的应用  

Application of different methods of hemodilution methods combined with autologous transfusion during operation

作　　者：伍国芳[1] 罗玉金[1] 彭冬华[1] 

机构地区：[1]湖南省娄底市中心医院麻醉科,湖南娄底417000

出　　处：《中国医学工程》2015年第8期3-4,6,共3页China Medical Engineering

摘　　要：目的评价不同血液稀释技术联合回收式自体输血对脊柱手术患者血液保护的效果及其安全性。方法 80例择期脊柱手术患者随机分为4组:A组(对照组)不行血液保护技术、B组单纯行回收式自体输血、C组行急性等容量血液稀释联合回收式自体输血、D组行急性高容量血液稀释联合回收式自体输血。监测麻醉诱导前(T1)、手术前(T2)、手术结束时(T3)及手术结束后24 h(T4)各组的红细胞压积(Hct)、血红蛋白(Hb)、血小板(PLT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、心率(HR)、平均动脉压(MAP)、中心静脉压(CVP);记录各组患者术中的输液量、自体血输注量、异体血输注量及尿量。结果与T1比较,各组患者CVP在T2、T3、T4均有不同程度的升高(P<0.05),T2时C组明显高A组(P<0.05);与T1比较,各组患者Hct、Hb均有不同程度的降低(P<0.05),与A组比较,T2时C、D两组低于A组(P<0.05);与T1比较各组患者PLT在T3、T4均下降(P<0.05),PT、APTT在T3、T4时均延长(P<0.05),但在正常范围之内;术中异体血输注量A组高于B组(P<0.05),明显高于C、D两组(P<0.01)。结论血液稀释技术联合回收式自体输血能明显减少术中的异体血输注量,对凝血功能影响小,安全可行。【Objective】To evaluate the effect and safety of different hemo dilution combined with autologous blood transfusion in lumbar surgery. 【Methods】80 cases of lumbar surgery were randomly divided into four groups（n=20） ： control group A（control group）,group B（autologous transfusion）,group C（acute normovolemic haemodilution combined with autologous blood transfusio）,group D（acute hypervolaemic haemodilution combined with autologous blood transfusio）.Hct、Hb、PLT、PT and APTT were measured at T1（before anesthesia induction） 、T2（before surgery） 、T3（the end of surgery） and T4（24 h after surgery）. transfusion volume、allogeneic transfusion volume、autologous transfusion volume、 urine volume were also measured. 【Results】Compared with T1,the levels of CVP was significantly increase in all groups, compared with group A, the levels of CVP was higher in group C at T2 compared with T1, the levels of Hct、Hb was decrease in all groups, compared with group A, the levels of Hct、Hb was higher in group C and group D at T2. compared with T1, the levels of PT、APTT was increase in all groups at T3 and T4,but all in normal scope. the allogeneic transfusion volume of group A was more than other groups. 【Conclusion】Haemodilution combined with autologous blood transfusion technology can significantly reduce blood loss and reduce allogeneic blood transfusion with a low rate of complications.

关 键 词：血液稀释 回收式自体输血 脊柱手术 

分 类 号：R826.64[医药卫生—临床医学]