不同自体输血方式的临床效果研究  

Clinical effects among different strategies of autologous blood transfusion

作　　者：徐爽[1] 周俊[2] 范亚欣[1] 郑井滨 王东博[1] 尹志群 毕晓琳[1] 高艳[3] 

机构地区：[1]辽宁省大连市血液中心,116001 [2]北京军区总医院,100700 [3]辽宁省大连市中心医院,116033

出　　处：《国际输血及血液学杂志》2017年第4期302-309,共8页International Journal of Blood Transfusion and Hematology

摘　　要：目的探讨不同自体输血方式的有效性，促进医疗机构开展自体输血工作，保障临床输血安全。方法采用简单随机抽样法随机选择2014年1月至2016年7月，于北京军区总医院或大连中心医院行骨科手术的88例自体输血患者作为研究对象。采用简单随机分组法，将其随机分为，术中自体红细胞回输组（n=43），储存式自体全血回输组（n=25）及储存式自体单采红细胞回输组（n=20）。采用简单随机抽样法，选择同期42例于受试者收集医院行骨科手术，并且术中仅接受异体输血的患者，纳入对照组（n=42）。记录并分析采血前／术前、输血后当天、输血后第4天，各组患者红细胞计数、血红蛋白（Hb）水平、血细胞比容（HCT）、血小板计数，以及患者住院天数、术中出血量、异体输血量等指标。采用统计学方法比较4组患者上述各项指标的差异。结果①本研究4组患者采血前／术前的红细胞计数、Hb水平、HCT、血小板计数分别比较，差异均无统计学意义（P〉0．05）。②输血后当天：4组患者的红细胞计数、Hb水平、HCT分别比较，差异均无统计学意义（P〉0．05）；4组患者的血小板计数比较，差异有统计学意义（F=4．157，P=0．008）。其中，储存式自体全血回输组患者的血小板计数最高[（196．0±43．8）×10^9／L]，高于术中自体红细胞回输组、对照组，并且差异均有统计学意义（P=0．004、0．009）；但是，与储存式自体单采红细胞回输组比较，差异无统计学意义（P=0．653）。③输血后第4天：4组患者的红细胞计数比较，差异无统计学意义（P〉0．05）；4组患者的Hb水平比较，差异有统计学意义（F=3．764，P=0．013）。其中，术中自体红细胞回输组的Hb水平最高[（115．6±23．8）g／L]，高于储存式自体全血回输组及对照组，并且差异均有统计学意义（P=0．022、0．006�Objective To investigate effectiveness of different strategies of autologous blood transfusion, in order to promote development of autologous blood transfusion in medical institutions, and to ensure the safety of clinical transfusion. Methods From January 2014 to July 2016, a total of 88 patients undergoing orthopedic surgery who received autologous blood transfusion in General Hospital of Beijing Military Region or Dalian Municipal Central Hospital, were randomly selected as research objects by simple random sampling method. A simple random grouping method was used to classify the patients into intraoperative salvaged autotransfusion group （n = 48）, stored autologous whole blood transfusion group （n= 25 ）, and stored autologous red blood cells transfusion group （n = 20）. A total of 42 patients undergoing orthopaedic surgery who received allogeneie blood transfusion were randomly selected from above hospital during the same period by simple random sampling method, and they were included in control group （n=42）. The data including patients＇ red blood cell count, hemoglobin （Hb） level, hematocrit （HCT） and platelet count were collected and analyzed in different time points which were before blood collection/ surgery, the first day after blood transfusion, the fourth day after blood transfusion. And days of hospitalization, volume of bleeding in the operation, infusion volume of allogeneic blood in each group were also collected and analyzed. Statistical methods were used to compare the differences of the above indexes among 4 groups. Results （i） There were no statistically significant differences in red blood cell count, Hb level, HCT, platelet count among patients of 4 groups before blood collection/surgery （P 〉 0. 05 ）. （1） There were no statistically significant difference in red blood cell count, Hb level, HCT among patients of 4 groups on the first day after blood transfusion. But there was significant differences in platelet count among 4 groups （F=4. 157, P=0

关 键 词：输血 自体 血液成分输血 单采红细胞 异体输血 

分 类 号：R457.1[医药卫生—治疗学]