深度自体储血技术在髋臼周围截骨术配对样本中的临床应用比较研究  

Study on advanced autologous apheresis for sample pairing in developmental dysplasia of hip surgery

作　　者：陈冠伊[1] 吴靖辉[1] 王丽华[1] 杨金华[1] 谷立男 卢祝杰 刘圣娥 陈蕾 欧阳锡林[1] 

机构地区：[1]解放军总医院第一附属医院输血科,北京100048 [2]承德市第三医院 [3]吉化集团公司总医院第二附属医院

出　　处：《中国输血杂志》2017年第12期1329-1332,共4页Chinese Journal of Blood Transfusion

基　　金：北京市科技计划课题(Z151100003915108)

摘　　要：目的分析单采深度自体储血技术(AAA)在髋臼周围截骨术中避免输注异体血的临床应用效果。方法统计2014年2月-2016年12月行髋臼周围截骨术治疗发育性髋关节发育不良手术病例,采用配对研究方法,将未采用AAA技术(即常规贮存自体全血及未采集自体血)的45例患者作为对照组;采用AAA技术进行单采深度自体储血患者,按照对照组患者的年龄、性别、体质指数、术前Hb和Plt、手术失血量、术中自体血回收量为条件,配对选择上述条件相似且均无统计学差异的45例患者作为深度自体组。配对比较分析2组患者自体浓缩红细胞采集量和采集率、异体红细胞和血浆输注量和输注率,围术期Hb和Plt变化,住院天数及住院费用。结果深度自体组和对照组患者术前采集自体红细胞量分别为146 U和14 U,自体血采集率分别为100.00%和17.78%;2组患者围术期异体红细胞和血浆的输注量分别为4 U vs 40 U和0 U vs 24 U,异体红细胞和血浆的输注率分别为4.44%vs40.00%、0.00 vs 26.67%;2组患者围术期Hb和Plt水平变化情况无统计学差异(P>0.05);2组患者的住院时间分别为11.0(9.5,12.0)vs 12.0(10.0,15.0)(P<0.05);2组的总住院费用、治疗费用、检查检验费用和输血相关费用分别为4.01(3.72,7.72)vs 4.47(3.58,7.70)(P>0.05),3.30(2.98,6.95)vs 4.00(23.04,7.14)(P>0.05),0.48(0.45,0.53)vs 0.47(0.44,0.50)(P>0.05),0.26(0.25,0.28)vs 0.06(0.04,0.15)(P<0.05)。结论对于发育性髋关节发育不良的髋臼周围截骨手术,单采深度自体储血技术能使90%以上患者避免异体血输注,同时缩短了住院时间,减少了患者的住院费用负担。Objective To evaluatethe application of advanced autologous apheresis（ AAA） in the Bernese periacetabular osteotomy（ PAO） for the treatment of developmental dysplasia of the hip（ DDH） in adults and to estimate its capability in reducingallogeneic transfusion during the treatment. Methods Between February 2014 and December 2016,90 DDHpatients were treated with PAO. An unbiased coupling strategy was adopted to pair 45 cases of non-AAA treated patients with 45 cases of AAAtreatedpatients with statistical-difference-freeage,sex,BMI,preoperative hemoglobin and platelet level,bleeding volume and the amount of intraoperative red blood cell（ RBC） salvage. Thus,acquiring the experiment group and the control group. The two groups were compared in the amount and the incidence of autologous blood donation and allogeneic RBC and allogeneic plasma transfusion,the level of perioperative hemoglobin and platelet,hospitalizationperiodlength and expenses. Results The amount and incidence of autologous blood donation in the experimentand the control group were 146 U vs 14 U,100. 00% vs 17. 78%,respectively. The amount and incidence of allogeneic red blood cells and plasma transfusionwere 4 U vs 40 U,0 U vs 24 U,4. 44% vs 40. 00%,0. 00 vs 26. 67%,respectively. The level of perioperative hemoglobin and platelet in two groups presents no statistical difference（ P〈0. 05）. The hospitalization period of the experiment group was shorter at 11. 0 d（ 9. 5,12. 0） vs 12. 0 d（ 10. 0,15. 0）（ P〈0. 05）. The total cost of hospitalization,treatment charges,examination and laboratory test expenses and blood transfusion related costs in two groups were 4. 01（ 3. 72,7. 72） vs 4. 47（ 3. 58,7. 70）（ P 〉 0. 05）,3. 30（ 2. 98,6. 95） vs 4. 00（ 23. 04,7. 14）（ P 〉0. 05）,0. 48（ 0. 45,0. 53） vs 0. 47（ 0. 44,0. 50）（ P〈0. 05）,0. 26（ 0. 25,0. 28） vs 0. 06（ 0. 04,0. 15）（ P 〉 0. 05）. Conclusion Forthe developmental dysplasia of the hip surgery,AAA can help 90% patients to avoid

关 键 词：单采深度自体储血技术 自体输血 髋关节发育不良 截骨术 

分 类 号：R457.12[医药卫生—治疗学] R681.6[医药卫生—临床医学]