腰椎术后自体血回输引流与单纯引流的对比研究  

Autologous blood transfusion drainage and simple drainage after lumbar surgery:A comparative study

作　　者：袁巧妹 贾育松[1] 李晋玉[1] 郑晨颖[1] 白春晓[1] 张帆[1] 邸学士 康晟乾 龙水文 陈江[1,2] YUAN Qiaomei;JIA Yusong;LI Jinyu;ZHENG Chenying;BAI Chunxiao;ZHANG Fan;DI Xueshi;KANG Shengqian;LONG Shuiwen;CHEN Jiang(The First Department of Orthopaedics,Dongzhimen Hospital,Beijing University of Tradi-tional Chinese Medicine,Beijing 100700,China;Hunan University of Traditional Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院骨伤科一区,北京100700 [2]湖南中医药大学

出　　处：《中国输血杂志》2021年第3期245-248,共4页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金(81603638);中国博士后科学基金(2019M662791)。

摘　　要：目的了解腰椎术后自体血回输引流和单纯引流对患者预后的影响。方法以本院骨科2018年8月~2020年9月住院行腰椎后路开放内固定+融合术的患者为对象,按术后采用的不同引流方式分为自体血回收引流组:从术后采用自体血回输装置引流的患者中随机抽取50名;单纯引流(对照)组:从术后采用引流袋引流的患者中随机抽取50名。回顾性比较分析2组患者的术后引流量、术后实际引流、总显性失血量、总自体血回输量,以及术后d1、d3、d7的贫血指标、感染指标及白蛋白水平。结果 2组患者的性别、年龄、手术耗时与手术节段具有可比性(P>0.05),术前Hb、Hct、ALB、WBC、NE%以及术中出血量、术中自体血回输量及术后实际引流量相近(P>0.05);术后d1、d3、d7的Hb、Hct、ALB、WBC、NE%、CRP,以及术前与术后的Hb、Hct、ALB差值,术后与术前的WBC、NE%、CRP差值均无明显差异(P>0.05)。自体血回收引流组与对照组患者术后引流量(mL)及总显性失血量(mL)分别为554.40±176.82 vs 337.80±102.43,1 048.40±282.87 vs 791.80±277.02(P<0.05)。结论腰椎术后采用自体血回输引流较单纯引流增加了患者引流量,而对患者贫血、白蛋白及感染等指标的改善不明显;患者腰椎术后不宜常规使用自体血回输装置引流。Objective To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. Methods The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. Results The gender, age, operation duration and operation segment of the 2 groups were comparable(P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar(P>0.05).There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP(P>0.05). The postoperative drainage volume(mL) and total dominant blood loss(mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively(P<0.05). Conclusion The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.

关 键 词：腰椎手术 自体输血 自体血引流回输 术后引流 

分 类 号：R457.1[医药卫生—治疗学] R681.5[医药卫生—临床医学]