自体血回输技术对行脊柱内固定手术患者术后血液流变学和骨折愈合的影响  

Influence of Autologuous Blood Transfusion on Hemorheology and Fracture Healing in Patients Undergoing Spinal Operation

作　　者：唐加华 吕毅[2] 芶大明[1] 李骅[3] TANG Jia-hua LV Yi GOU Da-ming LI Hua(Dept. of Anesthesiology, Zunyi Medical University, Zunyi Guizhou 563000 Dept. of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People＇s Hospital Shanghai 200233 Department of Orthopedics Surgery, The 1st Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650052, China)

机构地区：[1]遵义医学院麻醉学系,贵州遵义563000 [2]上海交通大学附属第六人民医院麻醉科,上海200233 [3]昆明医科大学第一附属医院骨科,云南昆明650032

出　　处：《昆明医科大学学报》2016年第7期78-81,共4页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81560080)

摘　　要：目的对术中行自体血回输的脊柱内固定手术患者术后血液流变学改变及骨折愈合程度进行探讨和评估.方法选取2012年1月至2014年12月择期行脊柱内固定术患者80例,按随机数字表法分成A、B 2组,A组施行自体血回输技术,B组施行异体输血.在术后第1、4、8、12周分别测定2组患者血液黏稠度、血浆黏度、红细胞压积、纤维蛋白原、血沉及血清s ICAM-1,s VCAM-1水平,并对上述指标进行统计分析.结果 A组术中输注的浓缩红细胞及血浆量明显低于B组,术后第4、8、12周A组的s ICAM-1,s VCAM-1水平明显低于B组,A组未出现骨折延迟愈合,B组有3个患者出现骨折延迟愈合,差异有统计学意义(P<0.05).2组患者术后第1、4、8、12周的血浆黏度,全血黏度(低切及高切)、纤维蛋白原、红细胞压积及血沉水平比较,差异无明显统计学意义(P>0.05).结论自体血回输技术不但是一种安全有效的输血方法,而且可以保证组织血供,减轻炎症反应,有利于骨折的正常愈合.Objective To explore and evaluate the changes of hemorheology and fracture healing in patients undergoing spinal operation with intraoperative autologuous blood transfusion. Methods A total of 80 patients underwent internal fixation of spine in our hospital from January 2012 to December 2014 were selected in this study. Digital random table method were utilized for dividing them into two groups. Autologous blood transfusion was used in group A, allogeneic blood transfusion was applied in group 13. Blood viscosity, plasma viscosity, hematocrit, fibrinogen, erythrocyte sedimentation rate （ESR） and the level of slCAM-1, sVCAM-I were collected and compared 1, 4, 8, 12 weeks after the operation. Results Concentrated red cell and plasma volume infusion in group A was lower than that in group B, the level of slCAM-1, sVCAM-1 1, 4, 8, 12 weeks after operation in group A were significantly lower than that in group B. There was no delayed fracture healing patients in group A, but there was 3 patients with delayed fracture healing in group B （P〈0.05） .Blood viscosity, plasma viscosity, hematocrit, fibrinogen, erythrocyte and ESR 1, 4, 8, 12 weeks after the operation compared in both group were not statistically significant （P〉0.05） .Conclusion Autologous blood transfusion is not only a safe and effective method for blood transfusion, but also can improve the tissue blood supply, reduce inflammation, and conducive to fracture healing.

关 键 词：自体血回输 骨折愈合 血液流变学 酶联免疫法 

分 类 号：R547[医药卫生—心血管疾病]