AHH联合术中血液回收对良性脑肿瘤患者的血液保护效果及血清APRIL、EFEMP1水平的影响  

Effects of Intraoperative Blood Recycling with AHH on Blood Protection and Serum APRIL and EFEMP1 Levels in Patients with Benign Brain Tumor

作　　者：梁冬 张宁 刘鹏[2] LIANG Dong;ZHANG Ning;LIU Peng(Neurovascular Surgery Department,First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471003,China;Operating Department,First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471003,China)

机构地区：[1]河南科技大学第一附属医院神经血管外科,河南洛阳471003 [2]河南科技大学第一附属医院手术部,河南洛阳471003

出　　处：《中国血液流变学杂志》2024年第1期98-101,140,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨急性高容量血液稀释(AHH)联合术中血液回收在良性脑肿瘤手术中的血液保护效果及对血清增殖诱导配体(APRIL)、包含表皮生长因子的fibulin类细胞外基质蛋白1(EFEMP1)水平的影响。方法选取2021年10月—2023年10月在河南科技大学第一附属医院接受良性脑肿瘤手术的88例患者,随机分为两组,每组44例。对照组采用常规输血方式,观察组采用AHH联合术中血液回收方式。比较两组患者的术中出血量、输血量、输血率、术后住院时间、术后并发症发生率、术前、术后24 h和48 h的血红蛋白(Hb)、血小板计数(PLT)、血清铁(Fe)、总铁结合力(TIBC)、铁饱和度(TSAT)、血清APRIL、EFEMP1水平等指标。结果观察组的术中出血量、输血量、输血率、术后住院时间、术后并发症发生率均低于对照组(P<0.05);观察组的术后24 h和48 h的Hb、PLT、Fe、TSAT水平均高于对照组,TIBC水平均低于对照组(P<0.05);观察组的术后24 h和48 h的血清APRIL、EFEMP1水平均低于对照组(P<0.05)。结论AHH联合术中血液回收在良性脑肿瘤手术中具有良好的血液保护效果,能够减少术中出血量、输血量、输血率,缩短术后住院时间,降低术后并发症发生率,改善患者的血液状态,降低血清APRIL、EFEMP1水平,可能与抑制肿瘤的生长和侵袭有关。Objective To investigate the effect of acute hypervolemic hemodilution(AHH)combined with intraoperative blood recycling on blood protection in benign brain tumor surgery and the levels of serum proliferation-inducing ligand(APRIL)and EGF-containing fibulin-like extracellular matrix protein 1(EFEMP1).Methods 88 patients with benign brain tumor were operated in First Affiliated Hospital of Henan University of Science and Technology from October 2021 to October 2023,and randomly divided into two groups.The control group got conventional blood transfusion,and the observation group received AHH combined with intraoperative blood recovery.The intraoperative blood loss,transfusion volume,transfusion rate,postoperative hospital stay,postoperative complication rate,and hemoglobin(Hb),platelet count(PLT),serum iron(Fe),total iron binding capacity(TIBC),transferrin saturation(TSAT),serum APRIL,EFEMP1 levels before operation and 24 h and 48 h after operation were compared between the two groups.Results The intraoperative blood loss,transfusion volume,transfusion rate,postoperative hospital stay,postoperative complication rate in the control group were lower than those in the observation group(P<0.05).The levels of Hb,PLT,Fe and TSAT in the observation group at 24 h and 48 h after operation were higher than those in the control group,but the levels of TIBC were lower than those in the control group(P<0.05).The serum APRIL and EFEMP1 levels in the observation group at 24 h and 48 h after operation were lower than those in the control group(P<0.05).Conclusion AHH combined with intraoperative blood recovery has a good blood protection effect in benign brain tumor surgery,which can reduce intraoperative blood loss,transfusion volume and transfusion rate,shorten postoperative hospital stay,reduce postoperative complications,improve patients'blood status and reduce serum APRIL and EFEMP1 levels,which may be related to inhibiting tumor growth and invasion.

关 键 词：AHH 术中血液回收 良性脑肿瘤 血液保护 APRIL EFEMP1 

分 类 号：R739.41[医药卫生—肿瘤] R730.56[医药卫生—临床医学]