去白细胞滤器对产科回收式自体输血红细胞回收率的影响  

Effect of leukocyte-depleted filter on erythrocyte recovery rate of obstetric recovery autologous blood transfusion

作　　者：李茹[1] 殷利军[1] 严海雅[1] LI Ru;YIN Li-Jun;YAN Hai-Ya(Department of Anesthesiology,Ningbo Women’s and Children’s Hospital,Ningbo,Zhejiang 315012,China)

机构地区：[1]宁波市妇女儿童医院麻醉科,浙江宁波315012

出　　处：《中国妇幼保健》2021年第24期5822-5825,共4页Maternal and Child Health Care of China

基　　金：浙江省宁波市医学科技计划项目(2016A28)。

摘　　要：目的分析去白细胞滤器对产科回收式自体输血红细胞回收率的影响,为临床实践提供参考依据。方法选取2018年8月-2019年2月在宁波市妇女儿童医院术中使用自体血回收机的出血量大于1000 ml的剖宫产产妇40例为研究对象,术中进行自体血回收、洗涤、去白细胞滤器过滤。采用全血自动分析仪分别测定经去白细胞滤器过滤前后红细胞平均体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDWR)、血红蛋白(Hb)、游离血红蛋白(FHb)、血清钾离子(K^(+))浓度及血清钠离子(Na^(+))浓度等变化,计算洗涤红细胞经去白细胞滤器过滤后的红细胞回收率和溶血率。结果产科术中回收自体血滤白前血液容积V_(滤前)为(251±13)ml,应用白细胞滤器后血液容积V_(滤后)为(200±14)ml,红细胞回收率为80.18%;滤白前,血清K^(+)水平为(0.07±0.06)mmol/L,血清Na^(+)水平为(149.79±1.29)mmol/L,FHb水平为(0.00±0.04)g/dl,Hb水平为(18.92±1.03)g/dl,溶血率为(0.20±0.13)%;滤白后,血清K^(+)水平为(0.06±0.03)mmol/L,血清Na^(+)水平为(150.07±1.13)mmol/L,FHb水平为(0.09±0.02)g/dl,Hb水平为(19.21±0.78)g/dl,溶血率为(0.20±.06)%。滤白前和滤白后血清K^(+)、Na^(+)、FHb、Hb水平及溶血率比较差异均无统计学意义(均P>0.05)。滤白前,MCV水平为(88.30±3.08)fl,MCH水平为(29.93±1.80)pg;滤白后,MCV水平为(91.58±2.79)fl,MCH水平为(32.57±2.25)pg。滤白前和滤白后MCV和MCH水平比较差异均有统计学意义(均P<0.05),滤白后显著升高。滤白前,MCHC水平为(33.93±1.01),RDWR水平为(15.86±2.31);滤白后,MCHC水平为(31.93±1.01),RDWR水平为(13.02±1.70)。滤白前和滤白后MCHC和RDWR水平比较差异均有统计学意义(均P<0.05),滤白后显著降低。结论产科术中自体血回收血液经去白细胞滤器过滤并不增加FHb,处于亚溶血损伤状态的红细胞被滤除,虽然降低了红细胞回收率,Objective To analyze the effect of leukocyte-depleted filter on erythrocyte recovery rate of obstetric recovery autologous blood transfusion,provide a reference basis for clinical practice.Methods From August 2018 to February 2019,forty cases of cesarean section were selected from Ningbo Women’s and Children’s Hospital as study object,all the cases were treated with autologous blood receive equipment,and the amount of hemorrhage was more than 1000 ml,autologous blood recovery,washing,and filtration of leukocyte-depleted filter were conducted during cesarean section.Whole blood automatic analyzer was used to detect the changes of mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular-hemoglobin concentration(MCHC),red blood cell volume distribution width(RDWR),hemoglobin(Hb),free hemoglobin(FHb),serum K^(+),and Na^(+)levels before and after filtration of leukocyte-depleted filter,the erythrocyte recovery rate and hemolysis ratio after filtration of leukocyte-depleted filter were calculated.Results Before filtration of leukocyte-depleted filter,blood volume Vbefore filtration of leukocyte-depleted filter was(251±13)ml;after filtration of leukocyte-depleted filter,blood volume Vafter filtration of leukocyte-depleted filter was(200±14)ml,the erythrocyte recovery rate was 80.18%.Before filtration of leukocyte-depleted filter,the level of serum K^(+)was(0.07±0.06)mmol/L,the level of serum Na^(+)was(149.79±1.29)mmol/L,the level of FHb was(0.00±0.04)g/dl,the level of Hb was(18.92±1.03)g/dl,erythrocyte hemolysis ratio was(0.20±0.13)%;after filtration of leukocyte-depleted filter,the level of serum K^(+)was(0.06±0.03)mmol/L,the level of serum Na^(+)was(150.07±1.13)mmol/L,the level of FHb was(0.09±0.02)g/dl,the level of Hb was(19.21±0.78)g/dl,erythrocyte hemolysis ratio was(0.20±.06)%.There was no statistically significant differences in the levels of serum K^(+),Na^(+),FHb,and Hb and erythrocyte hemolysis ratio between before filtration of leukocyte-depleted filter and after filtrati

关 键 词：去白细胞滤器 产科自体血回收 过滤效果 

分 类 号：R457.1[医药卫生—治疗学]