自体血回输对多发伤损伤控制性手术患者炎性细胞因子的影响  

Effect of autologous blood transfusion on inflammatory cytokines in multiple injury patients undergoing damage control operation

作　　者：王于昌 解杰[1] 白祥军[1] 宋先舟[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院创伤外科,武汉430030

出　　处：《临床急诊杂志》2016年第7期500-502,505,共4页Journal of Clinical Emergency

摘　　要：目的:探讨术中自体血回输对多发伤损伤控制性手术患者肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、c-反应蛋白(CRP)的影响。方法:选择我院2015-05-2016-01收治的多发伤损伤控制性手术患者30例,随机分为自体血回输组(IAT组)和异体血输注组(ABT组)2组,于麻醉诱导前、术后第1天、术后第3天用肝素抗凝试管采集空腹静脉血,ELISA方法检测血清中CRP、IL-6和TNF-α的表达水平。结果:2组患者在年龄、性别、术中出血量、术前血红蛋白量、术中输血量及受伤类型等比较差异无统计学意义,2组患者在输血第1天、第3天(T1、T2)TNF-α、IL-6较麻醉诱导前(T0)显著升高(P<0.05),CRP到T2时才显著升高(P<0.05);IAT组TNF-α、IL-6在T1、T2时显著低于ABT组(P<0.05),而2组CRP差异无统计学意义。结论:自体血回输能够降低多发伤损伤控制性手术患者TNF-α、IL-6炎症水平,对输血安全和临床治疗有重要意义。Objective：To evaluate the effect of intraoperative autologous blood transfusion（IAT）on inflammatory cytokines such as C-reactive protein（CRP）,interleukin-6（IL-6）and tumor necrosis factor（TNF-α）in patients with multiple trauma undergoing damage control operation.Method：Thirty multiple injury patients undergoing damage control operation were chosen in our hospital between May 2015 and Jan 2016,and were divided into two groups randomly,intraoperative autologous transfusion group（group IAT）and allogeneic blood transfusion group（group ABT）.CRP,IL-6and TNF-αwere measured by Enzyme-linked immune sorbent assay（ELISA）before anesthesia,on the first and third day after operation in two groups.Result：The general data such as age,sex,blood loss,preoperative hemoglobin,volume of blood transfusion and type of injury of patients in two groups showed no statistically differences.Compared with those on pre-anesthesia period（T0）,the level of TNF-αand IL-6on the first and third day（T1、T2）after operation in two groups increased significantly（P〈0.05）,but the level of CRP increased significantly until T2.Compared with that in group ABT,the level of TNF-αand IL-6on T1,T2 in group IAT was obviously lower（P〈0.05）,while the level of CRP in two groups had not statistically differences.Conclusion：Autologous blood transfusion can reduce the level of TNF-αand IL-6in multiple injury patients undergoing damage control operation,and has great significance to blood transfusion safety and clinical treatment.

关 键 词：自体血回输 多发伤 C-反应蛋白 白介素-6 肿瘤坏死因子-α 

分 类 号：R641[医药卫生—外科学]