醋酸钠林格液用作洗涤液对术中回收红细胞的影响  

Effect of Sodium acetate ringer’s solution used in autologous blood recovery on function of salvaged red blood cells

作　　者：万磊[1] 张雨洁[1] 金小平[1] 董鹏[1] 李修良[1] WAN Lei;ZHANG Yu-jie;JIN Xiao-ping(Department of Anesthesiology,Beijing Friendship Hospital,Captital Medical University,Beijing 100050,China.)

机构地区：[1]首都医科大学附属北京友谊医院麻醉科

出　　处：《临床和实验医学杂志》2019年第11期1208-1212,共5页Journal of Clinical and Experimental Medicine

基　　金：北京自然科学基金(编号:7122050)

摘　　要：目的评价醋酸钠林格液作为洗涤液应用于自体血液回收对红细胞功能的影响。方法采用前瞻性随机对照研究方法。2014年7月至2015年6月,使用自体血液回收机收集和洗涤在首都医科大学附属北京友谊医院行非停跳冠状动脉旁路移植手术30例患者的术野回收血液,按照随机数字表法将患者分为两组,每组各15例。对照组患者洗涤液使用生理盐水,试验组患者洗涤液使用醋酸钠林格液。比较两组患者的静脉血红细胞(从患者中心静脉抽取,时间点T1)和回收红细胞即刻(时间点T2)、回收红细胞21~24℃贮存4 h(时间点T3)和回收红细胞1~6℃贮存24 h(时间点T4)的钠离子(Na^+)、血糖(Glu)、乳酸(Lac^-)、钾离子(K^+)、溶血率、2,3-二磷酸甘油酸(2,3-DPG)和P50值(氧饱和度为50%时的氧分压值)。结果T1点:两组患者各指标相比差异无统计学意义(P>0.05)。与对照组相比,试验组患者T2、T3和T4点Na^+值(Na^+值mmol/L,实验组:141.17±2.14、141.83±3.19、139.67±0.82;对照组:153.78±2.44,152.33±2.40,147.11±4.17)显著降低(P<0.05);试验组患者T2和T3点Lac^-值(Lac^-值mmol/L,实验组:0.25±0.84,1.27±0.61;对照组:0.48±0.13,2.37±1.02)显著降低(P<0.05),T4点Lac^-值降低,但差异无统计学意义(P>0.05);试验组患者T2和T3点K^+值(K^+值mmol/L,实验组:4.08±0.13,4.17±0.15;对照组:0.59±0.26,1.72±0.37)显著升高(P<0.05),T4点时K^+值降低,但差异无统计学意义(P>0.05);试验组患者T2、T3和T4点Glu值(Glu值mmol/L,实验组:28.0±0.0、28.0±0.0、28.0±0.0;对照组:0.30±0.0,0.30±0.0,0.30±0.0)显著升高(P<0.05);试验组患者T2、T3和T4点溶血率、P50和2,3-DPG值差异无统计学意义(P>0.05)。结论醋酸钠林格液作为洗涤液对回收红细胞的洗涤和贮存效果优于生理盐水,能够改善回收红细胞的质量,可以节约异体红细胞使用。Objective To assess effect of Sodium acetate ringer’s solution used in autologous blood recovery on function of salvaged red blood cell(RBC).Methods This was a prospective randomized controlled study.From July 2014 to June 2015,thirty patients underwent elective off-pump coronary artery bypass grafting surgery in Beijing Friendship Hospital affiliated to Capital Medical University,whose blood was collected and processed using a blood recovery machine were enrolled in this study.The patients were randomly divided into two groups according to random number table,including control group(n=15),normal saline was used as washing solution,experimental group(n=15),Sodium acetate ringer’s solution was used as washing solution.Sodium(Na^+),blood sugar(Glu),lactate(Lac^-),potassium(K^+),hemolytic ratio,2,3-disphosphoglycerate(2,3-DPG)and P50(the oxygen partial pressure corresponding to 50%saturation of the hemoglobin with oxygen),of venous RBC(extracted from the patient’s central vein,time T1),salvaged RBC at 0 h(time T2),salvaged RBC at 4 h(storage at 21-24℃,time T3)and salvaged RBC at 24 h(storage at 1-6℃,time T4)of the two groups were compared.Results At T1 point,all indexes had no significant difference between two groups(P>0.05).Compared with the control group,the Na^+value at T2,T3and T4point in the experimental group(Na^+value mmol/L,experimental group:141.17±2.14,141.83±3.19,139.67±0.82;control group:153.78±2.44,152.33±2.40,147.11±4.17)decreased significantly(P<0.05).The Lac^-value at T2and T3point in the experimental group(Lac^-value mmol/L,experimental group:0.25±0.84,1.27±0.61;control group:0.48±0.13,2.37±1.02)decreased significantly(P<0.05),while the Lac^-value at T4point decreased but there was no statistical difference(P>0.05).The K^+value at T2and T3point in the experimental group(K^+value mmol/L,experimental group:4.08±0.13,4.17±0.15;control group:0.59±0.26,1.72±0.37)increased significantly(P<0.05),while the K^+value at T4point decreased but there was no statistical difference(P>0.05)

关 键 词：自体血液回收 醋酸钠林格液 红细胞 

分 类 号：R457.1[医药卫生—治疗学]