摘要
目的 探讨控制性降压复合自体血回输在大型脊柱手术中的应用效果。方法 选取2012年8月-2014年3月在本院行大型脊柱手术的58例患者作为研究对象,随机分成对照组和观察组,各29例。对照组仅采用控制性降压处理,观察组采用控制性降压复合自体血回输,比较两组的效果。结果 观察组的回收血量为（895±89）ml。两组的术中出血量比较,差异无统计学意义（P〉0.05）。观察组的异体输血量为（985±205）ml,显著少于对照组的（1960±245）ml,差异有统计学意义（P〈0.05）。两组术后的PT和APTT水平显著高于术前,PLT水平显著低于术前,差异有统计学意义（P〈0.05）。两组术后的PT、APTT、PLT水平比较,差异无统计学意义（P〉0.05）。两组手术前后的RBC水平比较,差异无统计学意义（P〉0.05）。两组术后的HCT和Hb水平显著低于术前,差异有统计学意义（P〈0.05）。两组手术后的HCT和Hb水平比较,差异无统计学意义（P〉0.05）。结论 在大型脊柱手术中采用控制性降压复合自体血回输能有效降低出血量,提高手术成功率,减少异体输血量,缓解医院血库的供血紧张问题,同时还避免了异体之间输血的免疫反应,不影响患者凝血功能,值得临床推广应用。
Objective To explore the application effect of controlled hypotension combined with autologous blood transfusion in large spinal surgery. Methods 58 patients received large spinal surgery in our hospital from August 2012 to March 2014 were selected and randomly divided into the control group and the observation group,29 cases in each group.The control group was only given controlled hypotension,and the observation group was given controlled hypotension combined with autologous blood transfusion.The effect in two groups was compared. Results The recycled blood volume in the observation group was（895±89） ml.There was no significant difference of the volume of bleeding during surgery in two groups（P〉0.05）.The allogenic transfusion volume in the observation group was（985±205） ml, which was less than（1960±245） ml in the control group,with significant difference（P〈0.05）.The level of PT and APTT after surgery in two groups was higher than that before surgery,and the level of PLT after surgery in two groups was lower than that before surgery,with significant difference（P〈0.05）.There was no significant difference of the level of PT,APTT and PLT after surgery in two groups（P〉0.05）.The level of preoperative and postoperative RBC in two groups was no significant in two groups（P〉0.05）.The level of HCT and Hb after surgery in two groups was lower than that before surgery,with significant difference（P〈0.05）.There was no significant difference of the level of HCT and Hb after surgery in two groups（P〉0.05）.Conclusion The application of controlled hypotension combined with autologous blood transfusion in large spinal surgery can effectively reduce volume of bleeding,improve successful rate of surgery,reduce allogenic transfusion volume,alleviate blood supply tension in hospital blood bank,and avoid the immunological reaction between allogenic transfusion at the same time,without influencing patients′coagulation function,it is worthy of clinical promotion and application.
出处
《中国当代医药》
2015年第23期31-33,36,共4页
China Modern Medicine
关键词
脊柱手术
控制性降压
自体血回输
Spinal surgery
Controlled hypotension
Autologous blood transfusion
