白细胞滤器用于术中自体血回输在创伤骨科患者中的临床疗效分析  

Clinical efficacy analysis of leukocyte filters for intraoperative autologous blood transfusion in orthopedic trauma patients

作　　者：张泽寅 左超 王强 ZHANG Zeyin;ZUO Chao;WANG Qiang(Department of Anesthesiology,the Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical University,Guangdong,Zhuhai 519100,China)

机构地区：[1]遵义医科大学第五附属(珠海)医院麻醉科,广东珠海519100

出　　处：《中国医药科学》2021年第15期10-14,共5页China Medicine And Pharmacy

基　　金：广东省珠海市医学科研基金项目(20191208A010070)。

摘　　要：目的观察分析白细胞滤器用于术中自体血回输在创伤骨科患者中的临床疗效。方法前瞻性研究2018年4月至2020年12月遵义医科大学第五附属(珠海)医院收治的择期在全麻下行骨折切开复位内固定术(ASA)分级Ⅰ级或Ⅱ级,术中需输血的患者120例,根据输血方法不同分为异体血输血组(A组)、自体血回输组(B组)、自体血通过白细胞滤器回输组(C组),每组各40例;比较三组患者的血常规、凝血功能、细胞因子水平、体温,输血后并发症,术后感染发生率及住院时间。结果NEU%在术后1 d及术后3 d时,B组最高;LYM%在术后1 d时,B组最低;TNF-α在术后1 d与3 d时,C组最低;IL-2在术后1 d时,A组最高;IL-6在术后1 d与3 d时,C组最低;在术后1 d时,B组体温最高(P<0.05)。三组术后未出现输血并发症与感染。结论自体血回输时加用白细胞滤器可减轻内固定术后患者炎症因子水平,促进术后康复。Objective To observe and analyze the clinical efficacy of leukocyte filters for intraoperative autologous blood transfusion in orthopedic trauma patients.Methods A prospective study was conducted on 120 patients admitted to the Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical University from April 2018 to December 2020.These patients underwent elective fracture open reduction and internal fixation under general anesthesia with ASA gradesⅠorⅡand required intraoperative blood transfusion.They were divided into the allogeneic blood transfusion group(group A),autologous blood transfusion group(group B)and autologous blood transfusion through leukocyte filters(group C)according to the different transfusion methods,with 40 cases in each group.The differences in blood routine examination,coagulation function,cytokine levels,temperature,post-transfusion complications,incidence of postoperative infection and hospitalization days were compared among the three groups.Results NEU%was the highest in group B at postoperative day 1 and day 3;LYM%was the lowest in group B at postoperative day 1;TNF-αwas the lowest in group C at postoperative day 1 and day 3;IL-2 was the highest in group A at postoperative day 1;IL-6 was the lowest in group C at postoperative day 1 and day 3;The body temperature was the highest in group B at postoperative day 1(P<0.05).No postoperative transfusion complications and infections were observed in the three groups.Conclusion The application of a leukocyte filter during autologous blood transfusion can reduce the level of inflammatory factors in patients after internal fixati on and promote postoperative recovery.

关 键 词：自体血回输 白细胞滤器 创伤骨科 疗效 

分 类 号：R457.1[医药卫生—治疗学]