自体血液回收机应用于急诊大出血手术的临床观察  

Clinical application effect of autologous blood recycling machine in emergency bleeding surgery

作　　者：张惠明 刘宏敏 倪宏云 赵永萍 孙倩倩 

机构地区：[1]香河县人民医院急诊科,河北香河065400 [2]香河县人民医院检验科 [3]香河县人民医院产科

出　　处：《临床血液学杂志（输血与检验）》2015年第6期1043-1046,共4页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:探讨血液回收机应用于急诊大出血手术的安全性和有效性。方法:选择采用血液回收机进行自体血液回输的56例急诊大出血患者为观察组,同期单纯输注异体血的相同或类似急诊患者61例为对照组。对观察组术前、自体血回输前后及术后24 h收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、中心静脉压(CVP)、心率(HR)、血氧饱和度(SpO_2)等生命体征指标和血红蛋白(Hb)、血细胞比容(HCT)及血小板计数(PLT)、凝血酶原时间(PT)和活化部分凝血酶时间(APTT)等血液指标进行检测,同时对2组术中失血量、异体血输注量、输血反应及输血费用进行比较。结果:①观察组自体血液回输后与回输前比较SBP、MAP及HR明显升高(P<0.05),血压维持正常,SpO_2无明显变化;观察组自体血回输后及术后与术前比较24 h Hb、HCT、PLT升高明显(P<0.05),PT及APTT无明显变化。②2组术中失血量差异无统计学意义,异体血输注量明显少于对照组(P<0.05)。观察组输血反应发生率和输血费用显著低于对照组(P<0.05)。结论:血液回收机应用于急诊大出血手术操作简单,快速有效回输自体血,减少输血反应和输血费用,具有重要的血液保护和临床应用价值。Objective：To observe the safety and effectiveness of intraoperative autologous blood transfusion using an autologous blood recycling machine in emergency bleeding surgery.Method：Fifty-six patients with massive hemorrhage performed intraoperative autologous blood transfusion using an autologous blood recycling machine were chosen as the observation group,61 cases of the same or similar emergency patients performed allogeneic blood transfusion as the control group.The vital signs as SBP,DBP,MAP,CVP,HR and SpO_2 were monitored,at the same time the blood indicators as HB,HCT,PLT,PT and APTT were examined for the blood samples taken before,after and during the operation in the observation group.Intraoperative blood loss,amount of allogeneic blood transfusion,blood transfusion reactions and blood transfusion cost were compared in two groups,Result：①After autologous blood transfusion,SBP,MAP and HR increased significantly,blood pressure was normal,SpO_2 had no obvious change in the observation group.Hb,HCT and PLT increased significantly（P〈0.05）,while PT and APTT had no obvious change.②Intraoperative blood losses were no obvious difference between two groups,and the allogeneic blood transfusion volume in the observation group was significantly less than that in the control group（P〈0.05）.The incidence of transfusion reactions and the cost of blood transfusion in the observation group were significantly lower than those in the control group.Conclusion：The operation of blood recycling machine applied for autologous blood transfusion in emergency bleeding may be simple,fast and efficient,which can significantly reduce the adverse reactions and cost of blood transfusion,and had important blood conservation and clinical application value.

关 键 词：血液回收机 自体血回输 大出血 急诊手术 

分 类 号：R457.1[医药卫生—治疗学]