腹主动脉瘤切除术和Bentall手术自体输血的应用分析  

Application of Autotransfusion in Abdominal Aortic Aneurysm Resection and Bentall Operation

作　　者：林静霞[1] 贺秋兰[1] 任俊[1] 高旖鑫 罗宏山[1] 周振海[1] LIN Jingxia;HE Qiulan;REN Jun;GAO Yixin;LUO Hongshan;ZHOU Zhenhai(The Eastern Hospital,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院,广东广州510080

出　　处：《现代医院》2018年第11期1639-1642,1645,共5页Modern Hospitals

摘　　要：目的通过观察腹主动脉瘤切除术伴人工血管置换术和带主动脉瓣人工血管升主动脉替换术(Bentall手术)手术中自体输血的应用情况,进一步探讨自体输血的推广应用。方法分析中山大学附属第一医院2014年9月—2018年5月这两类手术中运用自体输血技术的情况,并配对比较分析患者输注异体血或自体血的治疗效果。结果进行腹主动脉瘤切除术伴人工血管置换术53例,22例患者进行自体输血;进行Bentall手术40例,23例患者进行自体输血。腹主动脉瘤切除术伴人工血管置换术和Bentall手术自体输血组平均失血量较大,进行自体血回输后,对异体血量需求大大减少,且自体输血与异体输血对患者治疗效果方面无统计学差异。结论术中回收式自体输血能有效节约用异体血液,对于手术失血后改善贫血疗效显著,提倡更广泛应用自体输血技术。Objective To explore the effect of application of autologous blood transfusion in abdominal aortic aneurysm resection with artificial vascular replacement and ascending aorta replacement with man-made aortic valve （Bentall surgery） in our hospital. Methods We analyzed the data of patients undergoing these two types of operations in the Eastern Hospital of First Affiliated Hospital, Sun Yat-sen University, and compared and analyzed the treatment effects of patients transfusion with allogeneic blood or autologous blood. Results From September 2014 to May 2018, our hospital performed 53 cases of abdominal aortic aneurysm resection with artificial vascular replacement, and among them 22 patients received autotransfusion. Forty cases of Bentall surgery was performed and 23 of them patients received autotransfusion. The average blood loss in autologous blood transfusion group of the abdominal aortic aneurysm resection with artificial blood vessel replacement and in the Bentall operation was more severe. After autologous blood transfusion, the demand for allogeneic blood volume was greatly reduced, and there was no significant difference in the treatment effects between autologous blood transfusion and allogeneic blood transfusion. Conclusion Intraoperative recovery autologous blood transfusion can effectively save the resource of allogeneic blood. It has significant effect on improving anemia after blood loss in operation, and therefore it can be advocated for wider application.

关 键 词：自体输血 异体输血 腹主动脉瘤切除术伴人工血管置换术 BENTALL手术 血液保护 

分 类 号：R543.16[医药卫生—心血管疾病] R654.3[医药卫生—内科学]