自体血液回输技术对全麻下髋关节置换术患者凝血功能、炎症因子及免疫功能的影响  

Influence of autologous blood transfusion technology on coagulation function,inflammatory factors and immune function in patients undergoing hip replacement under general anesthesia

作　　者：赵燕 沈学庆 周亮 舒平 Zhao Yan;Shen Xueqing;Zhou Liang;Shu Ping(Department of Anesthesiology,Jiangyou Second People's Hospital,Mianyang Sichuan 621700,China;Department of Orthopedics,Jiangyou Second People's Hospital,Mianyang Sichuan 621700,China)

机构地区：[1]江油市第二人民医院麻醉科,四川绵阳621700 [2]江油市第二人民医院骨科,四川绵阳621700

出　　处：《保健医学研究与实践》2022年第7期34-38,共5页Health Medicine Research and Practice

摘　　要：目的探讨自体血液回输技术对全麻下髋关节置换术患者凝血功能、炎症因子及免疫功能的影响。方法选取2018年2月—2020年1月绵阳市某医院欲行全麻下髋关节置换术的96例患者为研究对象,采用随机数字表法分为对照组和观察组,每组48例。对照组患者行常规围术期管理干预,观察组患者采用自体血液回输技术干预。比较2组患者手术相关指标,比较2组患者术前1 d及术后7 d凝血功能[凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血酶原时间(APTT)]、炎症因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)]及免疫功能指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)及免疫球蛋白M(IgM)]水平。结果2组患者手术时间、术中出血量、术中补液量比较,差异均无统计学意义(P>0.05)。观察组患者异体输血量低于对照组,差异有统计学意义(P<0.05)。观察组患者平均自体输血量为(281.04±53.17)mL。术后7 d时,2组患者PT及APTT均短于术前1 d且观察组低于对照组,差异均有统计学意义(P<0.05)。术后7 d时,2组患者FIB均高于术前1 d且观察组高于对照组,差异均有统计学意义(P<0.05)。术后7 d时,2组患者IL-6及TNF-α水平均低于术前1 d且观察组低于对照组,差异均有统计学意义(P<0.05)。术后7 d时,2组患者IL-10水平均高于术前1 d且观察组高于对照组,差异均有统计学意义(P<0.05)。术后7 d时,2组患者IgA、IgM及IgG水平均低于术前1 d,差异均有统计学意义(P<0.05)。术后7 d时,观察组患者IgA、IgM及IgG水平均高于对照组,差异均有统计学意义(P<0.05)。结论自体血液回输技术可有效减少全麻下髋关节置换术患者异体输血量,改善患者凝血功能及免疫功能,减轻炎症反应,值得在临床上推广使用。Objective To investigate the effect of autologous blood transfusion technology on coagulation function,inflammatory factors and immune function in patients undergoing hip replacement under general anesthesia.Methods A total of 96 patients who underwent hip replacement under general anesthesia in a hospital in Mianyang City from February 2018 to January 2020 were selected as subjects.They were assigned to the control group(n=48)and the observation group(n=48)by the random number table method.The control group received routine perioperative management intervention,while the observation group received autologous blood transfusion technology intervention.The general operating conditions of the patients in the two groups were compared.The coagulation functions[prothrombin time(PT),fibrinogen(FIB),activated partial thrombostin time(APTT)],inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)]and immune function indicators[immunoglobulin A(IgA),immune globulin G(IgG)and immunoglobulin M(IgM)]were compared.Results There was no significant difference in operation time,intraoperative blood loss and intraoperative fluid replacement volume between the two groups(P>0.05).The amount of allogeneic blood transfusion in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The average volume of autologous blood transfusion in the observation group was 281.04±53.17 mL.At 7 d post-operation,the PT and APTT of the two groups were shorter than those at 1 d pre-operation,and the observation group was lower than the control group,with statistical significance(P<0.05).At 7 d post-operation,the FIB of both groups was higher than that at 1 d pre-operation,and the observation group was higher than the control group,with statistical significance(P<0.05).At 7 d post-operation,the levels of IL-6 and TNF-αin both groups were lower than those at 1 d pre-operation,and the observation group was lower than the control group,with statist

关 键 词：自体血液回输技术 全麻 髋关节置换术 凝血功能 炎症因子 免疫功能 

分 类 号：R684.7[医药卫生—骨科学]