单采自体红细胞回输技术在全髋关节置换术中的应用  

Application of apheresis autologous red blood cell transfusion in total hip arthroplasty

作　　者：房昆[1] 宋雪珍 任小宁[1] 汪德清[2] Fang Kun;Song Xuezhen;Ren Xiaoning;Wang Deqing(Department of Transfusion,Weihai Municipal Hospital,Weihai 264200,Shandong Province,Chin;Department of Transfusion,Chinese PLA General Hospital,Beijing 100853,Chin)

机构地区：[1]山东省威海市立医院输血科,264200 [2]中国人民解放军总医院输血科,北京100853

出　　处：《国际输血及血液学杂志》2018年第3期237-244,共8页International Journal of Blood Transfusion and Hematology

摘　　要：目的探讨单采自体红细胞回输技术在全髋关节置换术（THA）中的应用。方法选择2016年2月至7月，于中国人民解放军总医院接受THA治疗的191例患者作为研究对象。采用简单随机抽样法将患者分为研究组（n=91）和对照组（n=100）。研究组患者于THA前，进行单采自体红细胞，而对照组患者THA前未进行自体血液采集。分别记录研究组患者单采自体红细胞前和对照组患者接受THA前，2组患者接受THA后第1、3天的血常规检查主要指标，包括红细胞计数、血红蛋白（Hb）水平、白细胞计数、血小板计数。并且记录2组患者接受THA过程中的出血量，THA当天的异体输血量、异体输血率、异体红细胞输注量、异体红细胞输注率、异体血浆输注量、异体血浆输注率等指标。采用Mann-WhitneyU检验、Wileoxon符号秩检验或y。检验等统计学方法，分别比较2组患者上述各项指标的差异。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》的要求，分组征得受试者的知情同意，并与之签署临床研究知情同意书。研究组接受单采自体红细胞的患者于单采前，均签署单采自体红细胞的知情同意书。结果①本研究中，研究组患者单采自体红细胞前和对照组患者接受THA前、2组患者接受THA后第1、3天的红细胞计数中位数分别比较，差异均无统计学意义（P〉O．05）。研究组患者单采自体红细胞前的红细胞计数中位数分别较THA后第1、3天高，并且差异均有统计学意义（4．5×10^12／L比4．1×10^12／L，Z=-4．043、P〈0．001；4．5×10^12／L比3．7×10^12／L，Z=-6．754、P〈0．001）。对照组患者接受THA前的红细胞计数中位数分别较THA后第1、3天高，并且差异亦均有统计学意义（4．4×10^12／L比4．0×10^12／L，Z=-3．339、P〈O．001；4．4×10^12／L比3．7×10^12／L，Z=-5．018、P〈0．001）。②研究组�Objective To investigate the application of apheresis autologous red blood cell transfusion technology in total hip arthroplasty （THA）. Methods From February to July 2016, a total of 191 patients who received THA treatment in the Chinese PLA General Hospital were selected as the research subjects. All patients were randomly divided into study group （n = 91） and control group （n = 100） by simple random sampling method. Patients in the study group received autologous red blood cell apheresis before THA, while the control group did not collect any autologous blood before THA. The main blood indicators, including red blood cell count, levels of hemoglobin （Hb）, white blood cell count, platelet count, were recorded before apheresis in study group or before THA in control group, as well as on the 1st and 3rd day after THA in the 2 groups, respectively. The amount of blood loss during THA, allogeneie transfusion volume on the day of THA, allogeneic blood transfusion rate, allogeneic red blood cell transfusion volume, allogeneic red blood cell transfusion rate, allogeneic plasma transfusion volume, and allogeneie plasma transfusion rate were also observed. Mann-Whitney U test, Wilcoxon signed rank test or X^2 test were used to compare the difference of the above indications between the patients of 2 groups. The procedure of this study is in accordance with the requirements of the revised World Medical Association Declaration of Helsinki in 2013. Informed consent was obtained from each patient. Results ① In this study, there were no statistically significant differences in median red blood cell count of patients between study group before apheresis and that of control group before THA, as well as those of patients between the 2 groups on the 1st and 3rd day after THA （P〉0.05）. In study group, the median red blood cell count of patients before apheresis was higher than that of patients on the 1st and 3rd day after THA, and the differences were statistically significant （4.5×10^12/L vs 4.1×10^12/

关 键 词：输血 自体 关节成形术 置换 髋 血液成分输血 单采自体红细胞 自体血 

分 类 号：R457.1[医药卫生—治疗学] R687.4[医药卫生—临床医学]