摘要
背景:清洗式自体血液回输是将术野血经回收、抗凝、过滤、离心、浓缩、清洗后回输给患者的自体血液回输方式,在临床中已大量应用。目的:归纳总结清洗式自体回收血液的红细胞特点,包括红细胞的回收率和红细胞压积,红细胞的形状、变形能力、血流动力学和体内生存期的变化,红细胞携氧及供氧能力的变化以及红细胞免疫以及其表面膜受体的变化。方法:由第一作者检索1987年1月至2013年1月PubMed数据及万方数据库相关文献,英文检索词为"Blood transfusion,autologus,blood preservation,erythrocytes",中文检索词为"输血;自体;血液保存;红细胞"。计算机初检得到与清洗式自体回收血液的红细胞特点相关文献200篇文献,排除重复性研究,保留60篇做进一步总结分析。结果与结论:由于受负压吸引、离心分离等机械力、各种受损组织及细胞释放的炎性递质和酶类以及激活的补体等因素的共同作用,回收红细胞有一定程度的破坏,所以血液回收机对红细胞的总回收率取决于采集时的回收率、贮存破损率和清洗时的丢失率。自体血液回收对红细胞的携氧能力无明显影响,即回收血红细胞具有与正常红细胞相同的携氧能力。红细胞在自身输血前后免疫功能和表面受体的数量有所下降,但优于库存2周的红细胞。研究提示应提高血液回收技术以降低红细胞免疫黏附功能下降程度。
BACKGROUND：Autologous shed blood washing with the autologous transfusion system involving recovery, anticoagulation, centrifugation, concentrating and washing has been widely used in clinical practice.
OBJECTIVE：To clarify the characteristics of erythrocytes washing with autologous transfusion system, including recovery rate and hematocrit, the changes of shape, deformability, flow properties and in vivo half-life, oxygen carrying and delivering capacity and erythrocyte immunity and immunereceptor expression.
METHODS：The literatures published from January 1987 to January 2013 were retrieved by the first author in Wanfang and PubMed databases. Key words were“blood transfusion, autologus, blood preservation, erythrocytes”in English and Chinese. A total of 200 literatures relating to the erythrocyte characteristics in autologous blood transfusion were found by the computer, 60 of which were retained for further analysis after eliminating repetitive researches.
RESULTS AND CONCLUSION：Because of the mechanical force, such as negative pressure suction, centrifugal separation, and inflammatory mediators, enzymes, activated complements released by various damaged tissues and cells, the col ected erythrocytes were damaged to some extent. As a result, the total recovery rate of erythrocytes depended on the recovery rate, storage breakage rate and cleaning loss rate. The oxygen carrying capacity of erythrocytes was not influenced significantly by this procedure, so the recycled erythrocytes had the same oxygen carrying capacity with normal erythrocytes. To some extent, the number of surface receptors and immune function of recycled erythrocytes descended, but they were better than the erythrocytes preserved for 2 weeks. Studies suggested that blood recovery technology should be improved to reduce the functional decline in immune adherence of the recycled erythrocytes.
出处
《中国组织工程研究》
CAS
CSCD
2013年第40期7156-7162,共7页
Chinese Journal of Tissue Engineering Research
