自体输血与同种输血对脑外科手术患者术后细胞因子及脑氧合代谢的影响  

The Effect of Autologous Blood Transfusion and Allogeneic Blood Transfusion on Cytokines and Cerebral Oxygen Metabolism of Patients After Cerebral Surgery

作　　者：高春梅[1] 

机构地区：[1]河南省商丘市第一人民医院输血科,河南商丘476000

出　　处：《中国继续医学教育》2016年第32期65-67,共3页China Continuing Medical Education

摘　　要：目的 分析自体输血与同种输血对脑外科手术患者术后细胞因子及脑氧合代谢的影响,为临床脑外科手术输血方式的选择提供参考。方法 选取2012年3月-2016年6月我院接收脑外科手术患者52例,根据输血方式不同分为观察组（n=28）和对照组（n=24）,观察组采用自体输血,对照组采用同种异体输血,比较两组术前、术后3 d、术后7 d,IL-6、IL-10、TNF-α细胞因子变化情况和脑氧耗、脑氧摄取率、乳酸生成量变化情况。结果 术后3 d,观察组IL-6、TNF-α高于对照组,IL-10低于对照组,差异具有统计学意义（P〈0.05）;术后7 d,观察组IL-6、TNF-α高于对照组,IL-10低于对照组,差异具有统计学意义（P〈0.05）;术后3 d,观察组脑氧耗、乳酸低于对照组,脑氧摄取率高于对照组,差异具有统计学意义（P〈0.05）;术后7 d,观察组脑氧耗、乳酸低于对照组,脑氧摄取率高于对照组,差异具有统计学意义（P〈0.05）。结论 自体输血可改善脑外科手术患者术后脑氧合代谢情况,可作为脑外科输血的首选方法。Objective To study the effect of autologous blood transfusion and allogeneic blood transfusion on cytokines and cerebral oxygen metabolism of patients after cerebral surgery, to provide reference for the selection of operative blood transfusion in clinical department of cerebral surgery.Methods 52 cases of patients were selected from the Department of cerebral surgery operation from March 2012 to June 2016 in our hospital, according to the different blood transfusion, they were divided into observation group （n=28） and control group （n=24）. Autologous blood transfusion was used in the observation group. The control groupwas treated with allogeneic blood transfusion, the changes of IL-6, IL-10, TNF-α and the changes of cerebral oxygen consumption, oxygen uptake rate and lactic acid production were compared between two groups before and after operation 3 d, 7 d.Results After operation 3 d, the IL-6, TNF-α in the observation group were higher than control group, IL-10 was lower than the control group, the difference was statistically significant （P 〈 0.05）. After operation 7 d, observation group IL-6, TNF-α were higher than the control group, IL-10 was lower than the control group, the difference was statistically signiifcant （P 〈 0.05）. In the observation group, 3 d after operation, the oxygen consumption and lactic acid were lower than the control group, the oxygen uptake rate was higher than that of the control group, the difference was statistically signiifcant （P 〈 0.05）. In the observation group, 7 d after operation, the oxygen consumption and lactic acid were lower than the control group, the oxygen uptake rate was higher than that of the control group, the difference was statistically significant （P〈 0.05）.Conclusion Autologous blood transfusion can improve cerebral oxygen metabolism in patients undergoing operation in cerebral surgery. It can be used as the preferred method of blood transfusion in cerebral surgery.

关 键 词：脑外科手术 自体输血 脑氧合代谢 同种输血 

分 类 号：R642[医药卫生—外科学]