急性等容血液稀释结合术中自体血回输在脊柱手术中的应用  

Clinical Application of Acute Nomovolemic Hemodilution with Intraoperative Salvage Shed Blood in Spinal Surgery

作　　者：张继东[1] 张钟元[1] 董英海[1] 韩晓峰[1] 董宇启[1] 程光齐[1] 

机构地区：[1]上海第二医科大学附属仁济医院骨科,上海市200127

出　　处：《骨与关节损伤杂志》2003年第9期587-589,共3页The Journal of Bone and Joint Injury

摘　　要：目的 探讨急性等容血液稀释结合术中自体血回输在脊柱手术中临床应用的可行性。方法 38例腰椎滑脱行后路减压、椎弓根螺钉内固定加椎体间Cage融合术患者,随机分为三组,急性等容血液稀释结合术中自体血回输组(组Ⅰ,n=12);自体血回输组(组Ⅱ,n=12);对照组(组Ⅲ,n=14)。术中均采用控制性低血压,记录术前、术中、回输前、回输后、术后的血红蛋白和红细胞比容,分别记录回输的血量和输异体血量。结果 急性等容血液稀释结合术中自体血回输组术中输异体血量约100ml,自体血回输组输异体血量约400ml,对照组输异体血量约800ml,经统计学检验有显著差异(P<0.05)。结论急性等容血液稀释结合术中自体血回输在脊柱手术中临床应用是一种安全有效、节约血源的方法,可减少异体血输入,避免其并发症。Objective To evaluate the effect of acute nomovolemic hemodilution with intraoperative salvage shed blood on patients undergoing spinal surgery. Methods Thirty-eight patients with spondylolysis who underwent posterior spinal decompression, pedicle devices internal fixation, intervertebral fusion with cage were selected, and divided into three groups (group Ⅰ , n = 12, acute nomovolemic hemodilution with intraoperative salvage shed blood, groupⅡ, n=12, intraoperative salvage shed blood, group Ⅲ , n=14, as control group. ) Control hypotension was used in all cases throughout the surgical procedure. Hb and Hct were attenuated respectively at before operation, intraoperation, before autologous blood transfusion, after autologous blood transfusion, after operation. Volume returned from cell saver and homologous blood transfusion was detected. Results The average amounts of acute nomovolemic hemodilution with intraoperative salvage shed blood was 100 ml of homologous blood transfusion, 400 ml in cases of intraoperative salvage shed blood, and 800 ml in control group. There was significant difference among the groups. Conclusion This result suggests that acute nomovolemic hemodilution with intraoperative salvage shed blood in spinal surgery is a safe and effective method to decrease the need of homologous blood, avoids the complications of transfusion.

关 键 词：急性等容血液稀释 术中 自体血回输 脊柱手术 应用 

分 类 号：R687[医药卫生—骨科学]