急性等容稀释性自体输血对骨科手术患者围手术期凝血功能的影响  

Influence of acute normovolemic hemodilution autologous transfusion on coagulation function in orthopedic perioperation

作　　者：谢琦[1] 林舟丹[1] 张新华[1] 覃万安[1] 杨天明[1] 

机构地区：[1]中国人民解放军第三〇三医院骨科,广西南宁530021

出　　处：《中国现代医药杂志》2017年第10期4-6,共3页Modern Medicine Journal of China

基　　金：广西壮族自治区卫生厅自筹经费科研课题(编号:z2013546)

摘　　要：目的探讨急性等容稀释性(ANH)自体输血对骨科手术患者围手术期凝血功能的影响。方法连续纳入2013年1月~2016年5月于我院就诊的100例骨科手术患者,随机分为ANH组(急性等容稀释性自体输血,50例)和对照组(异体输血,50例)。比较两组患者手术前后血红蛋白(Hb)、红细胞比容(Hct)、血小板(PLT)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)及国际标准比值(INR)。结果两组患者术前各项指标差异无统计学意义(P>0.05)。术后1d,两组Hb、Hct、PLT、FIB明显下降(P<0.05),但ANH组Hb、Hct、PLT水平高于同期对照组(P<0.05);而两组PT、APTT、INR明显延长(P<0.05),但ANH组低于同期对照组(P<0.05)。结论急性等容稀释性自体输血对骨科手术患者凝血功能影响较小,而异体输血对骨科手术患者凝血功能抑制相对明显。骨科围手术期急性等容稀释性自体输血较异体输血具有明显的优势。ObjectiveTo investigate the influence of acute normovolemic hemodilution autologous transfusion （ANH）on coagulation function in orthopedic perioperation. MethodsOne hundred patients with orthopedics diseases in our hospital from Jan 2013 to May 2016 were enrolled in this study and divided into ANH group （acute normovolemic hemodilution autologous transfusion,n=50）and control group （homologous blood transfusion,n=50） equally and randomly. Hemoglobin （Hb）,hematocrit （Hct）,platelet （PLT）, prothrombin time （PT）,activated partial thrombin time （APTT）,fibrinogen （FIB）,international normalized ratio （INR）of the two groups were compared before and after operations. ResultsThere was no statistical difference in the indexes of the two groups before operations. Levels of Hb,Hct, PLT, FIB were decreased （ P〈0.05）, while levels of PT,APTT,INR were increased in the two groups one day after operations （ P〈0.05）. Levels of Hb,Hct, PLT in ANH group one day after operations were significantly higher than those in control group （ P〈0.05）,while levels of PT,APTT,INR were lower than those in control group （ P〈0.05）. ConclusionAcute normovolemic hemodilution autologous transfusion has no significant inhibitory effect on coagulation function while homologous blood transfusion does. ANH might has obvious superiority to homologous blood transfusion in orthopedic perioperation.

关 键 词：急性等容稀释性自体输血 骨科 围手术期 

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