摘要
目的探讨术中自体血回输(IAT)在脊柱外科大手术中的作用,以及对围手术期血常规和凝血功能指标的影响。方法选取49例接受术中自体血回输的患者为IAT组,以同期49例常规异体输血手术患者为库血组,比较两组输血量、术后血红蛋白(Hb)、红细胞压积(HCT)、血小板(PLT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)及术后并发症等情况。结果 IAT组中红细胞回收率为65.60%。术后IAT组49例患者中仅15例加用异体库血输注,回输自体血占总输血量的76.62%,平均异体输血量明显小于库血组,差异有统计学意义(t=69.70,P<0.05)。IAT组术后第1天Hb、HCT相对术前均有不同程度减少,PT显著延长,差异均有统计学意义(t分别=5.55、5.09、4.51,P均<0.05),IAT组术后第3天Hb、PT与术前比较,差异均有统计学意义(t分别=7.14、5.09,P均<0.05);但库血组Hb、PT在术后第3天与术前比较,差异均无统计学意义(t分别=0.77、0.84,P均>0.05);IAT组Hb、HCT和PT在术后第7天内亦能较快恢复,与术前比较,差异均无统计学意义(t分别=1.43、0.98、1.12,P均>0.05)。术后IAT组较库血组并发症少,差异有统计学意义(χ2=4.66,P<0.05)。结论 IAT技术可达到较高红细胞回收率,明显减少异体库血用量;术后并发症少,血液和凝血相关指标较快恢复,可安全应用于脊柱外科手术。
Objective To evaluate the effect of intraoperative autologous transfusion （IAT） in spinal surgery and its impact on perioperative blood parameters. Methods A total of 49 patients undergoing spinal surgeries with intraoperative autologous transfusion were selected as the ITA group while 49 patients with conventional allogenic blood transfusion were selected as control group. Blood transfusion volume, postoperative Hb, HCT, PLT, PT, Fbg as well as transfusion-related complications were compared between two groups. Results The autologous red blood cell salvage rate was 65.60%. In IAT group, only 15 patients received allogenic transfusions, and autologous blood made 76.62% of the total transfusion volume. The allogenic blood of ITA group is significantly less than control group （t=69.70,P〈0.05）. Compared with preoperative of IAT group, Hb and HCT of postoperation were significantly decreased while PT prolonged （t =5.55,5.09,4.51,P〈 0.05 ）. Compared with preoperation of the IAT group, the differences of Hb and PT after 3 days of postoperation were statistically significant （t=7.14,5.09, P〈 0.05 ）while that of control group had no statistical differeces （t=0.77,0.84, P〉 0.05 ）.These pa- rameters had no statistical differenece after 7 days of postoperation of the IAT group （t=1.43,0.98,1.12,P〉0. 05）. The complication ocurring of IAT group was less than that of the control group（χ2=4.66,P〈0.05）. Conclusions Intraoperative autologous transfusion had advantage of higher erythrocyte recovery, lower allogenic blood transfusion, fewer postoperative complications and faster recover of blood coagulation related index, so it could be securely applicated in spinal surgery.
出处
《全科医学临床与教育》
2012年第6期636-639,共4页
Clinical Education of General Practice
关键词
术中自体血回输
异体输血
脊柱手术
intraoperative autotransfusion
allogenic transfusion
spinal surgery
