微聚体滤器对自体血液回输患者术后肺功能的影响  

Effects of microparticle depletion filters on postoperative pulmonary function after intraoperative autologous blood transfusion

作　　者：罗琳[1] 陈梅珠[1] 高韵婷 LUO Lin;CHEN Meizhu;GAO Yanting(Department of Anesthesiology,Central South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院麻醉科

出　　处：《中国输血杂志》2018年第8期862-865,共4页Chinese Journal of Blood Transfusion

摘　　要：目的评价微聚体滤器对自体血液回输患者术后肺功能的影响。方法选择需自体血液回输的脑动脉瘤夹闭术患者40例,ASA分级Ⅱ或Ⅲ级,采用随机数字表法分为2组：对照组（C组,n=20）和微聚体滤器组（F组,n=20）。两组术中均采用自体血液回收,回输时F组使用微聚体滤器,而C组不用。分别取术前体内血（T0）、自体回收血（T1）、洗涤自体血（T2）、过滤自体血（T3）（F组）、回输前血（T4）回输后2 h、12 h、24 h（T5—7）时体内血各5 mL,检测血中白细胞计数（WBC）、血清丙二醛（MDA）、过氧化物歧化酶（SOD）和肿瘤坏死因子（TNF-α）、IL-6和IL-10含量;同时记录各时点呼吸参数、动脉血气,计算肺静态顺应性（Cstat）、氧合指数（OI）、呼吸指数（RI）。结果与C组比较,F组在T（5—7）时血中WBC和血清TNF-α、IL-6、MDA浓度和RI均降低,血清SOD浓度和Cstat、OI增高（P〈0. 05）;与T2比较,在F组T3时血中WBC明显减低（P〈0. 05）。结论微聚体滤器用于自体血液回输可减轻全身炎症反应,改善患者肺功能。Objective To evaluate the application effect of microparticle depletion filters on postoperative pulmonary function after intraoperative autologous blood transfusion. Methods Forty patients, considered to be American Society of Anesthesiologists（ASA） physical status Ⅱ or Ⅲ, with intracranial aneurysmal surgery were divided into 2 groups using a ran- dom number table： The control group （group C, n= 20） and The mieroparticle depletion filter group （group F, n = 20）. In- traoperative blood salvage was used on every patient. Microparticle depletion filters were applied on group F during autologous blood transfusion while none was used on group C. The total leukocyte count and the serum levels of MDA, SOD, TNF-α, IL-6 and lL-10 were measured on the following occasions： before anesthesia（T0） , before（T1） and after （T2） washing au- tologous blood, after filtering autologous blood （T3） , before reinfusion （T4） , 2, 12and 24 h after reinfusion （T5-7）. Mean- while the respiratory ventilation parameters and blood gas analysis were recorded. The static pulmonary compliance （Cstat） , oxygenation index（OI） and respiratory index（RI） were also calculated. Results Compared with group C, the WBC count and the serum IL-6, TNF-α and MDA concentrations and RI were significantly decreased in group F while the SOD concentrations, Cstat and OI increased at T5-7 （P〈0. 05） ; As for group F, compared with T2, the WBC count was significantly decreased at T3 （P〈0. 05 ）. Conclusion Reinfusion of microparticles-depleted intraoperative salvaged blood can inhibit inflammatory responses and improve the postoperative pulmonary function after intraoperative autologous blood transfusion.

关 键 词：微聚体滤器 自体血液回输 脑动脉瘤夹闭术 全身炎症反应 

分 类 号：R457.13[医药卫生—治疗学] R619[医药卫生—临床医学]