术中出血自体回输在外科手术中的应用研究.pdfVIP

墨壹 ：兰 鲎坦 旦 三_篷笙； 鲞笙 塑 · 2563 · 术中出血自体回输在外科手术中的应用研究 张春雷 朱 斌 陆启兵 周成学 徐玉清 张 年 【摘要】 目的 探讨术中出血自体回输在外科手术中应用的安全性、效果及所发挥的作用。 方法 自2006年6～l2月．通过应用国产自体一2000型血液回收机(北京京精医疗设备公司)在外科手 术中进行自体血回输。对45例病例预先随机分为试验组(A组)和对照组(B组)：A组3O例为采用术 中出血自体回输的患者；B组 l5例为完全输异体库存血的患者。并对患者术前、术后 24小时进行血常 规、凝血功能及血电解质检验，对部分回收血洗涤前、后分别行血细胞形态观察。结果 1)在试验组中 平均每例回收切口内失血(2 863士l 514)ml，经洗涤处理后平均每例有(1 009±560)ml(占35 )的浓缩 血细胞回输给患者，占总输血量的46 。但是仍然有83％的患者需及时补充异体血；2)切口内回收血 洗涤后在光镜下观察，大部分血细胞形态完整、清晰、结构正常，大多数细胞碎片已经被清洗掉。此外， 我们认为洗涤不会使白细胞产生空泡现象；3)采用自体血液回输后，血Ca 、K 均较术前有减少，血小 板也减少，差异均有非常显著性意义(P0．O1)。结论 应用术中出血自体回输是安全有效的，值得在 临床推广应用，但是不能对其过分依赖。 【关键词】 血液回收 自体输血 外科手术 The clinicalapplication of intraoperative autologous blood transfusion in surgical operation Zha ng Chunlei，et a1． (Shuyang hospital of TCM ，Jiangsu 223600 China) [Abstract] Objective 1o study the safety and efficacy of intraoperative atltologous blood transfu— sion in surgery．Methods From July 2006 to December 2006，intraoperative autologous blood transfu— sion was performed during surgical operation．using ZITI一2000 Autologous Blood Recovery System．45 patients was divided randomly into two groups of therapy and contro1．30 patients was set in A，which was the group of intraoperative autologous blood transfusion andl5 patients was set in B，which was the control group．Routine，plasmic electrolyt e and coagulative function were examined for the blood samples taken before operation and 24 hours after operation．Some collected blood samples were examined by light microscope．Results ①At group A mean2863±15l4 ml lost blood was collected from each patient and gotl009±560 ml(occupied 35％)concentrated blood cell after processed by ZITI一2000 Autologous Blood Recovery System in orthopedic surgery．It occupied forty～six percent of total amount of blood in— fusion during operation．But eighty—three percent of patients need infuse timely banked blood during op— eration．②Part of