自体血回输在胃肠胰外科大手术患者中的临床应用  

Clinical application of autologous blood transfusion in patients undergoing major surgery for gastrointestinal and pancreatic

作　　者：华程秀 吴颖[1] 纪超敏 HUA Chengxiu;WU Ying;JI Chaomin(Department of Gastrointestinal and Pancreatic Surgery,Zhejiang People′s Hospital,Hangzhou,Zhejiang 310014,China)

机构地区：[1]浙江省人民医院胃肠胰外科

出　　处：《重庆医学》2019年第23期4024-4026,共3页Chongqing medicine

摘　　要：目的 分析自体血回输在胃肠胰外科大手术患者中的临床应用及效果。方法 选取2016年1月至2018年10月该院择期行胃肠胰外科大手术的患者152例,按照输血类型的不同分成观察组(自体血回输)和对照组(输注异体血),每组76例。对比两组患者手术情况及免疫功能变化情况。结果 观察组输注异体血量,输血不良反应及切口感染发生率显著小于对照组(P<0.05);对照组术后1、7d的CD3+T细胞、CD4+T细胞、自然杀伤(NK)细胞、IgG及IgM水平,与术前比较显著下降,CD8+T细胞水平与术前比较显著上升(P<0.05);观察组以上指标与术前比较差异无统计学意义(P>0.05);观察组术后1、7d的补体C3水平较术前显著上升(P<0.05)。术后1、7d以上各项指标组间两两比较差异均有统计学意义(P<0.05)。结论 自体血回输在胃肠胰外科大手术患者中的临床应用效果较好,且对患者免疫功能并未造成明显影响,值得推广。Objective To analyze the clinical application and effect of autologous blood transfusion in patients undergoing major surgery for gastrointestinal and pancreatic.Methods A total of 152 patients undergoing major surgery for gastrointestinal and pancreatic from January 2016 to October 2018 were enrolled.The patients were divided into the observation group(autologous blood transfusion)and the control group(infusion of allogeneic blood)according to the different blood transfusion methods,there were 76 patients in each group.The surgical conditions and immune function of the two groups were compared.Results The amount of allogeneic blood transfusion,adverse reaction of transfusion and incidence of incision infection in the observation group were significantly lower than that in the control group(P<0.05).Compared with before surgery,the levels of CD3+T cells,CD4+T cells,NK cells,IgG,IgM in the control group on the 1st and 7th day after surgery were decreased,while the level of CD8+T cells was increased(P<0.05).Compared with before surgery,no significant difference was found in the indexes above in the observation group on the 1st and 7th day after surgery,while the level of complement C3 was increased.All the indexes above were found significant differences between the two groups at the time of 1st and 7th day after operation(P<0.05).Conclusion The clinical application of autologous blood transfusion in patients with major surgery for gastrointestinal and pancreatic is good,and it has no significant effect on the immune function of patients.It is worthy of promotion.

关 键 词：输血 自体 消化系统外科手术 免疫活性 

分 类 号：R656[医药卫生—外科学]