体外循环手术中血小板单采对血液的保护作用  

The effects of plateletpheresis on blood conservation during cardiopulmonary bypass

作　　者：周小玉[1] 汪承亚[1] 陈亦江[1] 周源[2] 

机构地区：[1]南京医科大学第一附属医院,江苏南京210029 [2]南京八一医院

出　　处：《中国输血杂志》2003年第1期3-6,共4页Chinese Journal of Blood Transfusion

摘　　要：目的　探讨在体外循环心脏手术中血小板单采对血液的保护作用 ;方法　选择 2 0例行心脏瓣膜手术患者 ,随机分为实验组和对照组 ,实验组采用血小板单采技术 +常规体外循环 ,对照组只采用常规体外循环 ,其他血液保护措施两组相同 ;结果　①实验组血小板采集量均在患者血小板总数的 2 0 %以上 ;②实验组术中血液制品 (全血和血浆 )用量较对照组明显减少 ,差异有显著性 ;③两组间Hb及Hct各时点变化趋势一致 ;④围手术期患者血小板计数的动态变化两组差异不大 ,而实验组恢复较快 ;⑤实验组术后血小板聚集功能明显优于对照组 ,差异有显著性 ;⑥实验组术后凝血酶原恢复时间明显较对照组快 ,差异有显著性 ;⑦实验组术后各分时段引流量较对照组明显减少 ,差异有显著性。结论　体外循环术中血小板单采能够保护血小板免遭体外循环的破坏 ,明显减少术后出血 ,起到良好的血液保护作用。Objective To investigate the effects of plateletpheresis on blood conservation following cardiopulmonary bypass.Methods 20 patients undergoing open heart surgery were divided randomly into experiment and control groups.All patients underwent routine CPB.Plateletpheresis was performed in experiment group by using COBE SPECTRA.Other blood conservation approaches were similar in two groups.Results The number of platelets collected in experiment group exceeded 20% of total platelets of every patients.In the experiment group,less transfusion was need.The changes of Hb and Hct at every time point were similar in the two groups.Platelet counts,aggregation,and prothrombin time in the experiment group restored to preoperative levels significantly earlier than in the control group.The chest tube drainage at 2,4,8,and 16 h and the total drainage after operation were significantly lower in the experiment group than those in the control group.Conclusion By protecting platelets from destruction by extracorporeal circulation,plateletpheresis is beneficial to the recovery of haemostatic system.It is a useful blood conservation method.

关 键 词：心脏外科手术 体外循环 血小板单采 血液 保护作用 

分 类 号：R654.1[医药卫生—外科学] R457.1[医药卫生—临床医学]