自体成分输血在1例Rh阴性体外循环心脏手术中的应用  

Application of blood component auto-transfusion in one Rh negative patient during cardioplumonary bypass operation

作　　者：马印图[1] 王更银[1] 李烛[1] 张怡[1] 董书文 李莉华[2] MA Yintu;WNAG Gengyin;LI Zhu;ZHANG Yi;DONG Shuwen;LI Lihua(Department of Blood Transfusion,Bethune International Peace Hospital,Shijiazhuang 050082,China;Hebei Blood Center)

机构地区：[1]解放军白求恩国际和平医院输血科,河北石家庄050082 [2]河北省血液中心

出　　处：《中国输血杂志》2019年第1期76-78,共3页Chinese Journal of Blood Transfusion

摘　　要：目的采用自体成分输血联合急性等容血液稀释的方式在体外循环心脏手术中为患者输血,评价其安全性,为高难度外科手术开展自体输血提供参考。方法在充分了解患者的临床资料和病史的基础上,采用术前蛙跳式自体成分贮血联合术中急性等容血液稀释的方式进行血液的采集和回输。结果患者在未输注异体血的情况下完成了体外循环下冠状动脉搭桥手术,患者在血液采集和回输过程中生命体征平稳,手术顺利,未出现输血不良反应。结论自体输血作为一种有效的血液保护手段,对于符合条件的择期手术患者应该积极开展自体成分输血,特别是稀有血型患者可以节省宝贵的血液资源,贮存式联合急性等溶血液稀释自体输血对心脏手术患者是安全、实用、经济的输血方式,值得临床上广泛使用。Objective To evaluate the safety of blood component autotransfusion combined with acute normovolemic hemodilution( ANH) in cardioplumonary bypass( CPB) open heart surgery,providing case reference for developing autotransfusion in complex surgical operation. Methods After carefully considering the clinical data and patient medical history,blood component autotransfution combined with ANH was proposed and planned for the transfusion. Results The surgery was successful and the patient recovered smoothly without transfusion homologous blood during perioperative period. The patient,s vital sign was stable with no transfusion adverse reactions. Conclusions The autotransfusion proposed an effective blood conservation approach. Patients are now offered with a promising option,especially for the rare blood type patients. The blood component autotransfusion combined with ANH in heart surgical operation,in this case,was safe,practical,low blood consumption, and worth promoting in clinical practices.

关 键 词：冠心病 体外循环术 血液稀释 自体输血 稀有血型 循证输血 

分 类 号：R457.11[医药卫生—治疗学] R654.1[医药卫生—临床医学]