儿童脊柱侧弯术中自体血回输对凝血功能的影响  

Children with Scoliosis Intraoperative Autologous Blood Transfusion on Coagulation Function

作　　者：张慧敏[1] 马曙轩[1] 王孟键 邱立娟[1] 

机构地区：[1]首都医科大学附属北京儿童医院输血科,100045

出　　处：《临床输血与检验》2017年第6期551-553,共3页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的分析自体血回输对儿童脊柱侧弯术中凝血功能的影响。方法 198例采用自体血回输技术的脊柱侧弯患儿,根据回输血量占循环血容量的比例分为3组,A组:回输血量小于循环血容量的10%,B组:回输血量占循环血容量的10%~50%,C组:回输血量大于循环血容量的50%。分别检测手术前,回输前后血红蛋白(Hb)、红细胞压积(HCT)、血小板计数(PLT)、凝血酶原时间(PT)、部分凝血酶原时间(APTT)、纤维蛋白原含量(FIB)。结果 A组回输后Hb和HCT比回输前提高(P<0.05),PLT和凝血功能指标差异无统计学意义(P>0.05)。B组回输后Hb和HCT较回输前上升,PT、APTT延长,FIB降低(P<0.05)。C组回输后较回输前PLT和凝血功能减退更明显(P<0.05),回输后Hb、HCT较回输前有明显提高(P<0.05)。结论儿童脊柱侧弯术中回输自体血有利于减少患儿失血量和异体血输注。对于大量失血患儿,术中需监测患儿凝血功能,及时补充新鲜血浆、血小板或其他凝血因子。Objective Analysis of effect ofintraoperative autologous transfusion on coagulation function in patients with scoliosis. Methods According to transfusion volume accounted for the proportion of circulating blood volume, 198 cases scoliosis with autologous blood transfusion technology were divided into 3 groups： group A transfusion volume is less than 10% of the circulating blood volume, group B transfusion volume of circulating blood volume accounted for 10%-50%, group C transfusion volume greater than the circulating blood volume 50%, hemoglobin （Hb） , hematocrit （HCT） , platelet （PLT） , prothrombintime （PT） , partial thromboplastin time （APTT） , fibrin original （FIB） were detected before and after transfusion. Results In group A Hb and HCT were increased after reinfusionthan （P〈0.05） , but PLT and coagulation function without significant difference （P〉0.05） .In group B, compared to before reinfusion, Hb and HCT were increased （P〈0.05） , PT, APTT were prolonged, FIB was decreased after reinfusion （P〈0.05） .In group C, transfusion after reinfusion, PLT and coagulation function significantly were decreased, （P〈 0.05） , while Hb, HCT significantly improved （P〈0.05） .Conclusion Autologous blood transfusion in children＇s scoliosis surgery is beneficial to reduce blood loss and allogeneic blood transfusion. For a large amount of blood loss, it is required for intraoperative monitoring of coagulation function, timely replenishment of fresh plasma, platelets or other coagulation factors.

关 键 词：儿童 脊柱侧弯矫正术 自体血回输 凝血功能 

分 类 号：R682.13[医药卫生—骨科学] R457.1[医药卫生—外科学]