体外肺膜氧合支持治疗患者自体血回输的回顾性分析  

Retrospective analysis of autologous blood transfusion in 11 cases of extracorporeal pulmonary membrane oxygenation therapy

作　　者：邱芳[1] 鲁玉凤[2] 朱颖[1] QIU Fang;LU Yufeng;ZHU Ying(Department of Blood Tramfusion,The First Affiliated Hospital of Gannan Medical University,Gaiizhou 341000,China;Department of Critical Care Medicine,The First Affiliated Hospital of Gannan Medical University,Gaiizhou 341000,China)

机构地区：[1]赣南医学院第一附属医院输血科,江西赣州341000 [2]赣南医学院第一附属医院重症医学科,江西赣州341000

出　　处：《中国输血杂志》2020年第2期130-132,共3页Chinese Journal of Blood Transfusion

摘　　要：目的对11例体外肺膜氧合(ECMO)支持治疗患者自体血回输的回顾分析,探讨自体血回输在体外肺膜氧合支持治疗中的临床应用及疗效评价。方法选择2018年10月-2019年5月行ECMO治疗的患者,在其心肺功能恢复,撤机后,将体外管道内的血液收集于一次性使用塑料血袋内,处理后再进行回输。比较回输前后血液分析及凝血功能的变化,对自体血回输后疗效进行评价;对回收后的血液检测5d内的溶血率及进行细菌培养,对贮存血液质量进行评价。结果行ECMO治疗患者自体血回输后,Hb、Plt结果较自体血回输前明显升高,输血疗效显著;凝血功能无明显变化。自体血在2-6℃环境下保存5 d内溶血率远低于国家血液质量标准,连续5 d细菌培养无菌生长,所有患者均未发生输血不良反应。结论行ECMO治疗的患者自体血回输疗效显著、安全可靠、费用低廉。随着ECMO技术的推广,为避免血液浪费,有效节约血液资源,切实降低输血风险,自体血回输技术可广泛应用于ECMO患者。Objective To examine the curative effects of autologous blood transfusion in 11 patients undergoing extracorporeal membrane oxygenation(ECMO) therapy and evaluate the clinical benefits and efficacy of autologous blood transfusion in patients undergoing ECMO therapy. Methods The patients treated with ECMO from October 2018 to May 2019 were selected,after cardiopulmonary function recovery and weaning, the blood in the external pipeline was collected in a disposable blood collection bag, and then transfused.To compare the changes of blood analysis and coagulation function before and after reinfusion,evaluate the curative effect of autologous blood reinfusion, evaluate the hemolysis rate & bacterial culture in 5 days after blood detection, and evaluate the quality of stored blood. Results The level of Hb and Plt increased significantly in ECMO patients after autologous hemotherapy, showing a good curative effect. Patients′ coagulation function did not vary significantly before and after autologous hemotherapy. The hemolysis rate of autologous blood stored at 2-6℃ for 5 days was in the range required for a national standard, and no bacterial growth was observed within 5 d of culture. No adverse reactions of autologous blood transfusion occurred in the patients.Conclusion Autologous hemotherapy is effective, safe and low cost for patients undergoing ECMO. With the promotion of ECMO therapy, autologous blood transfusion can be further applied in ECMO patients, so as to reduce bank blood requirements.

关 键 词：自体血回输 体外肺膜氧合 重症心肺疾病 

分 类 号：R457.1[医药卫生—治疗学] R459.7[医药卫生—临床医学]