不同洗涤模式的自体血回收对脊柱手术患者血液回收质量的影响  

Effects of intraoperative autotransfusion with different washing modes on quality of salvaged blood in patients undergoing spinal surgery

作　　者：张帆 施琼[2] 杨国仁[1] ZHANG Fan;Sill Qing;YANG Guo-ren(Department of Anesthesiology ,Jianyang People＇s Hospital,Jianyang 641400, China;Department of Anesthesiology, The 17 4 th Hospital of Chinese People＇s Liberation Army ,Xiamen361000 , China)

机构地区：[1]四川省简阳市人民医院麻醉科,四川简阳641400 [2]福建省厦门市解放军第一七四医院麻醉科,福建厦门361000

出　　处：《实用医院临床杂志》2018年第3期110-113,共4页Practical Journal of Clinical Medicine

基　　金：四川省卫计委普及应用项目(编号:17PJ228)

摘　　要：目的探讨不同洗涤模式的自体血回收对脊柱手术患者血液回收质量的影响。方法选取2017年1~8月择期行脊柱手术且术中行自体血回收的患者46例,按随机数字表法分为标准模式组和紧急模式组各23例。标准模式组选择标准模式进行自体血回收,紧急模式组选择紧急模式进行自体血回收。比较两组洗涤前后血液中游离血红蛋白(fHb)、乳酸脱氢酶(LDH)、白蛋白(ALB)、钙离子(Ca^(2+))含量、洗涤后血液中游离血红蛋白清除率(CR_(fHb))、乳酸脱氢酶清除率(CR_(LDH))、白蛋白清除率(CR_(ALB))及钙离子清除率(CR_(Ca^(2+)))及CR_(fHb)与CR_(LDH)、CR_(ALB)及CR_(Ca^(2+))的相关性。结果洗涤后,两组间血中fHb、LDH、ALB及Ca^(2+)含量与洗涤前相比明显降低(P<0.05),且两组间差异有统计学意义(P<0.05)。洗涤后,标准模式组CR_(LDH)及CR_(Ca^(2+))高于紧急模式组(P<0.05)。标准模式组和紧急模式组CR_(fHb)均与CR_(LDH)具有一定相关性(r=0.815;r=0.753,P<0.05)。结论两种模式自体血回收均能够有效减少清除回输血中的fHb浓度,CR_(fHb)与CR_(LDH)相关性较好。Objective To explore the effects of intraoperative autotransfusion with different washing modes on quality of salvaged blood in patients undergoing spinal surgery.Methods Forty-six patients undergoing elective spinal surgery between January 2017 and August 2017 were randomly divided into standard mode group（ SM group） and emergency mode group（ EM group）,23 in each group.The SM group used standard mode while the EM group used emergency mode for intraoperative blood salvage.The concentrations of free haemoglobin（ fHb）,lactate dehydrogenase（ LDH）,albumin（ ALB） and Ca^2＋before and after washing were compared in the two groups.The clearance rates of fHb（ CRfHb）,LDH（ CRLDH）,ALB（ CRALB） and Ca^2＋（ CRCa^2＋） as well as the correlations among the CRfHb,CRLDH,CRALBand CRCa^2＋were analyzed.Results After washing,the concentrations of fHb,LDH,ALB and Ca^2＋were lower than these before processing（ P〈0. 05）,and the concentrations of these blood factors between the two groups were significant different（ P〈0. 05）.Compare with the EM group,the CRLDHand CRCa^2＋were higher in the SM group（ P〈0. 05）. In the two washing modes,the CRLDHwere significantly associated with the CRfHb（ r= 0. 815,P〈0. 05 and r= 0. 753,P〈0. 05,respectively）.Conclusion Both models of intraoperative autotransfusion can effectively reduce the concentration of fHb in the salvaged blood,and the CRLDHis significantly associated with the CRfHb.

关 键 词：自体血回收 游离血红蛋白 乳酸脱氢酶 白蛋白 钙离子 

分 类 号：R614[医药卫生—麻醉学]