成分单采技术在预存式自体输血中的应用研究  

Study of apheresis application on preoperative autologous blood donation

作　　者：周俊[1] 晋晶[1] 武广隆[1] 张秋丽[1] 庞力[1] 

机构地区：[1]北京军区总医院输血科,北京100700

出　　处：《中国输血杂志》2016年第3期239-242,共4页Chinese Journal of Blood Transfusion

摘　　要：目的将成分单采技术用于预存式自体输血,评估其在成分式预存自体输血中的安全性、有效性。方法以普外科、骨科的择期手术患者中符合预存式自体输血指证患者109例为研究对象,分析比较术前采集自体全血、成分单采自体红细胞及未进行自体血预存的3组患者,术前、术后1 d、3 d Hb、Hct、Plt变化,及术后异体血输注率、术后平均住院日等指标,评价预存式自体成分输血的有效性。结果自体成分血组患者术后1 d、3 d Hb(117.66±18.02)g/L vs.(118.4±16.79)g/L vs.(143.6±10.96)g/L,P<0.05;Hct(36.26±4.63)%vs.(36.24±4.85)%vs.(43.17±3.15)%,P<0.05;Plt(201.29±58.09)×109/L vs.(202.28±48.06)×109/L vs.(240.11±72.29)×109/L,P<0.05均较术前下降;与术前比较自体全血组患者术后1 d、3 d Hb(139.43±12.11)g/L vs.(114.93±15.87)g/L vs.(112.72±17.9)g/L,P<0.05;Hct(42.45±3.08)%vs.(35.73±4.3)%vs.(34.08±5.44)%,P<0.05;Plt(242.36±56.25)×109/L vs.(205.84±65.73)×109/L vs.(197.89±54.71)×109/L,P<0.05均降低;对照组术后1 d、3 d较术前Hb(117.7±18.42)g/L vs.(112.62±18.2)g/L vs.(139.97±11.12)g/L,P<0.05;Hct(35.33±5.26)%vs.(33.73±5.42)%vs.(42.33±3.86)%,P<0.05;Plt(166.27±57.74)×109/L vs.(154.08±55.75)×109/L vs.(216.13±82.21)×109/L,P<0.05均降低,但3组患者术后Hb>110 g/L,Hct≥33%。3组患者术后1 d、3 d Hb、Hct变化差异无统计学意义(P>0.05),自体成分血组及自体全血组术后1 d、3 d Plt高于对照组(P<0.05)。自体成分血组与对照组比较有效缩短了术后平均住院日(17.93±7.13)d,(13.09±5.58)d,P<0.05,与自体全血组比较差异无统计学意义(13.09±5.58)d,(14.39±5.13)d,P>0.05。自体成分血组患者的异体血输注率与自体全血组比较差异无统计学意义(11.4%,22.7%,P>0.05)。结论将成分单采技术用于自体成分血输注,有利于缩短平均住院时间,降低异体血输注率,此技术用于自体成分输血具有可行性,安全有效。Objective To evaluate the effect of preoperative autologous blood donation （PABD） using apheresis on the patients undergoing elective surgical procedures, and to investigate the clinical feasibility. Methods 109 patients undergo- ing general, orthopedics elective surgery were analyzed. The control group consisted of patients who did not donate autologous blood; the transfusion allogeneic blood group contained patients who donated autologous blood using red blood cells aphere- sis; the whole blood （WB） PABD group consisted of patients who donated whole blood. In all patients on preoperative and postoperative days 1 and 3, the Hb, Hct and Ph were measured and compared. The postoperative recovery indices of the three groups were compared, including allogeneic blood transfusions aitd postoperative length of stay. Results On the post- operative days 1 and 3, the Hb, Hct and PLT of three groups were lower than preoperative, but theHb was greater than 110 g/L, Hct was not less than 33%. Patients who donated autologous blood using red blood cells apheresis had the following pa- rameters： Hb （117.66 ±18.02）g/Lvs. （118.4 ±16,79）g/Lvs. （143.6 ± 10.96）g/L, P〈0.05; Hct （36.26 ±4.63）g/ Lvs. （36.24±4.85）% vs. （43.17±3.15）%, P〈0.05; Pit（201.29±58.09） ×10^9/Lvs. （202.28±48.06） ×10^9/L vs. （240. 11 ±72.29） ×10^9/L, P〈0.05. In the WB PABD group, their parameters were as followed： Hb （139.43 ± 12. 11）g/L vs. （114.93 ±15. 87）g/Lvs. （112.72 ±17.9）g/L, P〈0.05, Hct （42.45 ±3.08）% vs. （35.73 ±4.3）% vs. （34.08±5.44）%, P〈0.05, Ph（242.36 ±56,25） ×10^9/Lvs. （205.84±65.73） ×10^9/Lvs. （197.89±54.71） ×10^9/L,P 〈0.05. There were no significant differences in Hh and Hct drop value on the first and third days after operation a- mong three groups （P 〉 0.05）. The PLT in the control were lower than WB PABD and transfusion allogenic group （P 〈 0.05）. The postoperative hospital stay in red blood cells apheresis PABD group

关 键 词：预存式自体输血 血液成分单采 择期手术 

分 类 号：R457.1[医药卫生—治疗学]