红细胞悬液预先洗涤法预防小儿脊柱侧弯矫形术中高钾血症的效果研究  

Application of washing red cell suspension before transfusion in the prevention of hyperkalemia in children undergoing with scoliosis orthomorphia

作　　者：杜萍 许华晔 朱慧杰 崔士和[1] Du Ping;Xu Hua-ye;Zhu Huijie;Cui Shihe(Department of Anesthesiology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属南京鼓楼医院麻醉手术科,南京210008

出　　处：《中国医师进修杂志》2020年第11期969-972,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:探讨红细胞悬液预先洗涤法预防小儿脊柱侧弯矫形术中高钾血症的应用价值。方法:选取南京大学医学院附属南京鼓楼医院2018年1月至2019年12月脊柱侧弯畸形患儿32例,均择期行脊柱侧弯畸形矫形术。将患儿按随机数字表法分为试验组和对照组,每组16例。试验组术中异体红细胞悬液经血液回收机洗涤后再输入,对照组术中常规输入异体红细胞悬液。检测两组患儿术前、输血前、输血后和术后血钾。记录两组手术时间、输自体血、尿量、术中出血量、异体血量、出入量及术中血钾>5.0 mmol/L及输血相关不良反应的发生情况。结果:两组手术时间、输自体血、尿量、术中出血量、异体血量和出入量比较差异无统计学意义(P>0.05)。两组术前和输血前血钾比较差异无统计学意义(P>0.05);对照组输血后、术后血钾明显高于输血前[(4.5±0.7)和(3.9±0.3)mmol/L比(3.7±0.2)mmol/L],差异有统计学意义(P<0.05);试验组输血后血钾明显高于输血前[(3.9±0.2)mmol/L比(3.8±0.2)mmol/L],差异有统计学意义(P<0.05);试验组输血后血钾明显低于对照组,差异有统计学意义(P<0.01);两组术后血钾比较差异无统计学意义(P>0.05)。对照组术中3例患儿发生一过性血钾>5.0 mmol/L,其中1例患儿血钾>6.7 mmol/L,术中发生心跳骤停;试验组未发生血钾>5.0 mmol/L。两组患儿均未发生输血相关不良反应。结论:红细胞悬液预先洗涤法用于小儿脊柱侧弯矫形术可明显降低患儿输血后血钾,有效避免术中高钾血症的发生。Objective:To evaluate the effect of washing red cell suspension before transfusion in the prevention of hyperkalemia in children undergoing scoliosis orthomorphia.Methods:Thirty-two children who had underwent scoliosis orthomorphia from January 2018 to December 2019 in Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University,were selected.The children were divided into experiment group and control group by random digits table method with 16 cases each.In experiment group,the red cell suspension was washed by cell-saver before transfusion;in control group,the red cell suspension was infused routinely.Potassium concentration before operation,before blood transfusion,after blood transfusion and after operation was detected.The operation time,autologous blood transfusion,urine output,bleeding volume,allogeneic blood transfusion volume,intake and output,intraoperative blood potassium>5.0 mmol/L and blood transfusion related adverse reactions were recorded.Results:There were no statistical differences in operation time,autologous blood transfusion,urine output,bleeding volume,allogeneic blood transfusion volume,intake and output between 2 groups(P>0.05).There was no statistical difference in blood potassium before operation and before blood transfusion between 2 groups(P>0.05).In control group,the blood potassium after blood transfusion and after operation was significantly higher than that before blood transfusion:(4.5±0.7)and(3.9±0.3)mmol/L vs.(3.7±0.2)mmol/L,and there was statistical difference(P<0.05);in experiment group,the blood potassium after blood transfusion was significantly higher than before blood transfusion:(3.9±0.2)mmol/L vs.(3.8±0.2)mmol/L,and there was statistical difference(P<0.05);the blood potassium after blood transfusion in experiment group was significantly lower than that in control group,and there was statistical difference(P<0.01);there was no statistical difference in blood potassium postoperative between 2 groups(P>0.05).In control group,3 cases had transient blood pot

关 键 词：高钾血症 儿童 脊柱侧凸 血液成分输血 外科手术中自体血液回收 

分 类 号：R726.8[医药卫生—儿科]