两种晶体溶液在术中自体血回输中的临床疗效观察  

Clinical effects of infusing different crystal solution on salvage of shed blood

作　　者：朱丽坤[1] 温洁新[2] 

机构地区：[1]河北省中医院检验科,河北石家庄050011 [2]河北医科大学第一医院输血科

出　　处：《中国输血杂志》2015年第10期1244-1246,共3页Chinese Journal of Blood Transfusion

摘　　要：目的观察自体血液回收中输注不同晶体溶液的临床应用效果。方法以河北省中医院2011年3月-2015年2月,98名失血性休克急诊手术患者为研究对象。按入院顺序将98名患者分为观察组和对照组,奇数入观察组,偶数入对照组,每组49例。观察组在自体血液回收中输注醋酸林格氏液,对照组输注乳酸林格氏液。观察2组患者自体血回输前、回输后2 h、24 h的心率(HR)、平均动脉压(MAP)及毛细血管充盈时间(CFT),以及静脉血红细胞(RBC)、血红蛋白浓度(Hb)。记录2组术前失血量、术后回收血量及术中输血不良反应,检测和比较2组术前和术后24 h血乳酸水平、Plt、ALT等。结果 1)98名急诊手术患者,术中自体血经血液回收机回收后,均获得血细胞压积为65%的浓缩血液,并于术后2 h内回输给患者。回输后MAP、RBC、Hb比术前明显增高,HR、CFT比术前明显下降,差异比较均有统计学意义(P<0.01或<0.05);2)2组患者术中均未观察到过敏、溶血等不良反应。2组术前失血量、术后回收血量以及术前血乳酸水平、Plt及ALT比较无明显差异(P>0.05)。观察组术后24 h血乳酸水平、ALT与术前相比无明显变化(P>0.05),Plt明显升高(P<0.01),与对照组比较差异也有统计学意义(P<0.01);对照组术后24 h血乳酸水平、ALT比术前明显升高(P<0.01)。结论在自体血回收时,输注醋酸林格氏液可改善回收血质量,防止血乳酸水平明显升高,同时对血小板和肝功能也具有一定的保护作用,值得临床推广应用。Objective To observe the clinical effects of infusing different crystal solution on autologous blood salvage. Methods 98 cases of patients with emergency surgery were selected as research objects in Hebei Chinese Medical Hospital between March 2011 and February 2015. According to admission order, 98 patients were divided into the observation group arid control group ： an odd number was placed into the observation group, an even number into the control group, with 49 ca- ses in each group. Ringer＇s solution of acetic acid was applied in the observation group and Ringer＇s solution of lactic acid was applied in control group at the time of autologous blood salvage. Heart rate （HR） , mean arterial pressure （MAP） , heart rate （ HR）, capillary filling time （CFT）, red blood cell （RBC） and hemoglobin （HGB） were observed before operation, at 2 h, 24 h after autologous blood transfusion in all patients. Preoperative blood loss, postoperative recovery of blood and intra-operative blood transfusion reactions were recorded in two groups. Lactic acid level, platelet （Plt） and Alanine transaminase （ALT） before operation and 24 h after operation were detected and compared in two groups. Results 1 ）. Intraoperative au- tologous blood in 98 cases of patients with emergency surgery were recycled by using the recycling machine. Red blood cells deposited at 65% were obtained, and were transfused to the patients within 2 hours after surgery. MAP, RBC, HCB signifi- cantly increased after autologous blood transfusion and were higher than those before operation. HR and CFT significantly de- creased and were lower than those before operation. The differences were statistically significant （P 〈 0. 01 or 〈 0.05 ）. 2）. Adverse reactions such as allergies, hemolysis were not found in either groups. Preoperative blood loss, postoperative recov- ery and preoperative lactic acid level, Ph and ALT had no statistically significant difference between two groups （ P 〉 0. 05 ）. Compared with the

关 键 词：自体血液回收 输注 醋酸林格氏液 乳酸林格氏液 

分 类 号：R457.1[医药卫生—治疗学] R619[医药卫生—临床医学]