术中自体血回输技术对骨科手术患者血流动力学及血液氧合功能的影响  

The Effect of Intraoperative Autologous Blood Transfusion Technique on Hemodynamics and Blood Oxygenation Function in Orthopedic Surgery Patients

作　　者：王启富 邓路平 张欢 WANG Qifu;DENG Luping;ZHANG Huan(Anesthesiology Department,Liuzhi Special District People's Hospital of Guizhou Province,Liupangshui 553400,Guizhou,China)

机构地区：[1]贵州省六枝特区人民医院麻醉科,贵州六盘水553400

出　　处：《系统医学》2024年第14期45-48,共4页Systems Medicine

摘　　要：目的探讨骨科手术中自体血回输的效果。方法目的选取2020年4月—2023年12月拟在贵州省六枝特区人民医院行骨科手术患者80例,按治疗方案不同分为异体血组(n=40)和自体血组(n=40),前者术中输注同种异体血,后者术中行自体血回输。对比两组血液氧合功能、血流动力学、凝血功能。结果术后自体血组动脉血氧分压(483.74±22.67)mmHg、混合静脉血氧饱和度(76.25±6.33)%,高于异体血组(465.78±21.39)mmHg、(71.89±6.42)%,氧摄取率(0.31±0.09)%低于异体血组(0.37±0.10)%,差异有统计学意义(t=3.644、3.059、2.821,P均<0.05)。对比两组术前、术后平均动脉压、心率和中心静脉压指标,差异无统计学意义(P均>0.05)。对比两组术前、术后纤维蛋白原、凝血酶原、部分活化凝血活酶时间,差异无统计学意义(P均>0.05)。结论骨科术中使用自体血回输和异体血输注对凝血功能和血流动力学影响较小,但自体血回输可更好地改善血液氧合功能。Objective To explore the effect of autologous blood transfusion in orthopedic surgery.Methods Eighty patients who were scheduled to undergo orthopedic surgery at the People's Hospital of Liuzhi Special District,Guizhou Province from April 2020 to December 2023 were objectively selected.They were divided into an allogeneic blood group(n=40)and an autologous blood group(n=40)according to different treatment method.The former received intraoperative infusion of allogeneic blood,while the latter received intraoperative autologous blood transfusion.Compare the blood oxygenation function,hemodynamics,and coagulation function between two groups.Results After surgery,the PaO2 detection value in the autologous blood group was(483.74±22.67)mmHg,and the SvO2 detection value was(76.25±6.33)%,which was higher than(465.78±21.39)mmHg,(71.89±6.42)%in the allogeneic blood group,ERO2 detection value was(0.31±0.09)%,lower than(0.37±0.10)%in the allogeneic blood group,the differences were statistically significant(t=3.644,3.059,2.821,all P<0.05);There was no statistically significant difference in preoperative and postoperative mean arterial pressure(MAP),heart rate(HR),and central venous pressure(CVP)between the two groups(all P>0.05);There was no statistically significant difference in fibrinogen(FIB),prothrombin time(PT),and activated partial thromboplastin time(APTT)between the two groups before and after surgery(all P>0.05).Conclusion The use of autologous blood transfusion and allogeneic blood transfusion during orthopedic surgery has little impact on coagulation function and hemodynamics,but autologous blood transfusion can better improve blood oxygenation function.

关 键 词：骨科手术 自体血回输 血流动力学 凝血功能 血液氧合功能 

分 类 号：R614[医药卫生—麻醉学]