改良贮存式自体输血联合OrthoPAT回输技术用于人工全膝关节置换术后出血的效果观察  

Effect of improved storage type of autologous blood transfusion combined with shed blooding retransformation technique after OrthoPAT for artificial total knee arthroplasty

作　　者：沈文生[1] 任志伟[1] 邵瑾[1] 李丹升[1] 潘路平[1] 楼洁[1] 

机构地区：[1]绍兴市中医院麻醉科,浙江省绍兴312000

出　　处：《中国基层医药》2016年第14期2081-2085,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省绍兴市公益性技术应用研究计划（2013870086）

摘　　要：目的观察改良贮存式自体输血联合OrthoPAT术后引流血回输技术用于人工全膝关节置换术后出血的临床疗效。方法将人工全膝关节置换术患者70纠黟用随机数字表法分为观察组和对照组各35例，其中观察组给予改良贮存式自体输血联合OrthoPAT术后引流血回输，对照组给予常规异源性输血；记录两组麻醉前瞬时、手术中、自体血回输前10min、回输后15min、手术后6h及24h各时间点血红蛋白值和凝血功能；记录24h引流血总量，异体血输入量和异体输血率。结果两组各个时间血流动力学稳定，尿量差异无统计学意义（均P〉0．05）；两组各个时间段上凝血状况均正常，各时间内结果值比较差异均无统计学意义（均P〉0．05）；观察组平均输血量及异体输血量率分别为（126．3±6．5）mL和1／35，均显著低于对照组的（476．4±10．6）mL和32／35，比较差异有统计学意义（t=10．73，χ2=6．31，均P〈0．05）；观察组术后并发症发生率5．7％，显著低于对照组的22．9％，两组比较差异有统计学意义（χ2=4．93，P〈0．05）。结论改良贮存式自体输血联合OrthoPAT术后引流血回输技术用于人工全膝关节置换术后出血功效确切，不良反应发生率低，明显降低了输异体血比率。Objective To investigate the clinical effect of modified storage type of autologous blood transfusion combined with shed blooding retransformation technique after OrthoPAT for artificial total knee arthroplasty. Methods 70 patients with total knee replacement were randomly divided into observation group and control group, 35 cases in each group. The observation group was treated with the modified storage autotransfusion combined shed blooding retransformation technique after OrthoPAT, while the control group was given conventional allogeneic blood transfusion. The hemoglobin values and blood coagulation function of the two groups at immediately before anesthesia and surgery, 10min before autologous blood transfusion and after reinfusion of 15min, after 6h and 24h of surgery were recorded, and the drainage blood total value, allogeneic blood transfusion measurement issues and transfusion rate after 24h were recorded. Results The hemodynamics of the two groups were stable at each time,there were no difference at urine volume （ all P 〉 0. 05 ）. The coagulation conditions were normal of the two groups at each time, there were no statistically significant differences between the two groups （ all P 〉 0.05）. The average volume and homologous blood transfusion rate in the observation group were （126.3 ±6.5 ）mL, 1/35, which were significantly lower than those in the control group [ （476.4 ±10.6 ） mL, 2/35 ], the differences were statistically significant （ t = 10.73, X2 = 6.31, all P 〈 0.05 ）. The incidence rate of postoperative complication of the observation group was 5.7%, which was signifi- cantly lower than 22.9% of the control group, the difference between the two groups was statistically significant （X2 = 4.93,P 〈 0.05）. Conclusion The improved storage type of autologous blood transfusion combined with shed bloo- ding retransformation technique after OrthoPAT has exact effect for artificial total knee arthroplasty, the incidence of adverse reactions is low, as well as the low blood

关 键 词：自体输血 OrthoPAT 全膝关节置换术 

分 类 号：R457.1[医药卫生—治疗学] R687.4[医药卫生—临床医学]