复方电解质注射液对术中回收红细胞回输后患者Hb及RBC的影响  

Impact of intraoperatively salvaged and multiple electrolyte injection washed blood on hemoglobin and erythrocyte count in orthopedic patients

作　　者：王菁 代小梅 芶大明 WANG Jing;DAI Xiaomei;GOU Darning(Department of Anesthesiology,the First Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学第一附属医院麻醉科

出　　处：《中国输血杂志》2019年第11期1120-1123,共4页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金资助项目(81560080)

摘　　要：目的了解复方电解质注射液洗涤的术中回收(IBS)红细胞回输患者时间<3 d血浆Hb及RBC的变化情况。方法选择46名择期行骨科手术且做IBS的患者,分别以生理盐水(NS组,n=24)和复方电解质液(MEI组,n=22)洗涤IBS红细胞,于术前、术(输)后即刻、术(输)后1-3 d取2组患者静脉血2 mL/人(份),检测Hb、RBC并记录术中2组失血量、回收红细胞净输入量和术后引流量等。结果2组患者术前一般情况、手术时间、回收红细胞离体时间、术中失血量、回收红细胞净输入量相近(P>0.05)。术前、术(输)后即刻及术(输)后1-3 d Hb(g/L),组内比较:NS组术前vs术(输)后即刻为121.4±14.5 vs 109.0±18.3、术(输)后1 d vs术(输)后2 d为110.0±16.7 vs 102.8±17.7、术(输)后2-3 d vs术(输)后即刻为102.8±17.7 vs 101.7±15.6 vs 109.0±18.3(P<0.01);术(输)后即刻vs术(输)后1 d为109.0±18.3 vs 110.0±16.7、术(输)后2 d vs术(输)后3 d为102.8±17.7 vs 101.7±15.6(P>0.05),MEI组术前vs术(输)后即刻为127.3±14.0 vs 112.0±14.4、术后(输)即刻vs术(输)后1 d为112.0±14.4 vs 119.8±15.7、术(输)后1 d vs术(输)后2 d为119.8±15.7 vs 106.6±16.3(P<0.01);术(输)后2 d vs术(输)后3 d为106.6±16.3 vs 107.3±15.0、术(输)后2-3 d vs术(输)后即刻为106.6±16.3 vs 107.3±15.0 vs 112.0±14.4(P>0.05);组间比较:NS与MEI组术(输)后1 d为110.0±16.7 vs 119.8±15.7(P<0.05)、其余时间的检测值2组相近(P>0.05)。术前、术(输)后即刻、术(输)后1-3 d RBC(×10^9/L),组内比较:NS组分别为术前vs术(输)后即刻为3.91±0.49 vs 3.52±0.63、术(输)1 d vs术(输)2 d为3.56±0.59 vs 3.31±0.56、术(输)后2-3 d vs术(输)后即刻为3.31±0.56 vs 3.30±0.53 vs 3.52±0.63(P<0.01);术(输)后即刻vs术(输)后1 d为3.52±0.63 vs 3.56±0.59、术(输)后2 d vs术(输)后3 d为3.31±0.56 vs 3.30±0.53(P>0.05),MEI组分别为术前vs术(输)后即刻为4.13±0.43 vs 3.67±0.47、术(输)后即刻vs术(输)1 d为3.67±0.47 vs 3.92±0.55、术(输)后1 d vs术(输)2Objective To investigate the changes of plasma hemoglobin(Hb)contents and erythrocyte count 3 days after the transfusion of salvaged red blood cells(RBCs)washed with multiple electrolyte injection and 0.9%saline.Methods A total of 46 patients(n=46)who underwent orthopedic surgery and intraoperative blood salvage(IBS)were randomly divided into normal saline group(group NS,n=24)and multiple electrolyte injection group(group MEI,n=22).2 mL of venous blood from 2 groups of patients was collected before surgery,immediate after surgery/transfusion,and 1 to 3 days after surgery/transfusion,respectively.Hb and RBC were detected;intraoperative blood loss,net salvaged RBCs and postoperative drainage were recorded.Results The two groups had similar preoperative general conditions,operation time,in vitro time of salvaged RBCs,intraoperative blood loss,and salvaged RBCs net input(P>0.05).The intra-group comparison of Hb(g/L)preoperative,immediate after surgery/transfusion,1-3 days after surgery/transfusion in group NS was as follows:Hb(g/L)preoperative vs.immediate after surgery/transfusion was 121.4±14.5 vs.109.0±18.3;1 day after surgery/transfusion vs.2 day after surgery/transfusion was 110.0±16.7 vs.102.8±17.7;2-3 days after surgery/transfusion vs.immediate after surgery/transfusion was 102.8±17.7,101.7±15.6 vs.109.0±18.3(P<0.01);immediate after surgery/transfusion vs.1 day after surgery/transfusion was 109.0±18.3 vs.110.0±16.7;2 day after surgery/transfusion vs.3 day after surgery/transfusion was 102.8±17.7 vs.101.7±15.6(P>0.05);in group MEI,Hb(g/L)preoperative vs.immediate after surgery/transfusion was 127.3±14.0 vs.112.0±14.4;immediate after surgery vs.1 day after surgery/transfusion was 112.0±14.4 vs.119.8±15.7;1 day after surgery/transfusion vs.2 day after surgery/transfusion was 119.8±15.7 vs.106.6±16.3(P<0.01);2 day after surgery/transfusion vs.3 day after surgery/transfusion was 106.6±16.3 vs.107.3±15.0;2-3 days after surgery/transfusion vs.immediately after surgery/transfusion was 106.6±16.3,10

关 键 词：复方电解质注射液 术中血液回收 回收红细胞回输 血红蛋白 红细胞计数 自体输血 

分 类 号：R457.1[医药卫生—治疗学] R331.141[医药卫生—临床医学]