摘要
目的分析并探讨心脏瓣膜置换术中应用急性等容性血液稀释(acute normovolemic hemodilution,ANH)联合回收式自体输血的体会。方法选取2018年6月-2019年6月期间在该院行心脏瓣膜置换术者50例,麻醉维持平稳后进行ANH,术后将处理过的纯净、浓缩的红细胞收集后回输给患者,观察患者平均采血量、术中出血量、回收式自体输血量、补液量、术后1 h引流量、异体血浆输注量及住院时间,操作过程中是否存在输血反应、肉眼血尿及血液污染现象。结果患者术中生命体征平稳,平均采血量(392.37±45.65)mL,术中出血量(845.39±56.76)mL,回收式自体输血量(596.45±75.21)mL,补液量(1029.73±205.21)mL,术后1 h引流量(32.76±10.57)mL,异体血浆输注量(1.64±1.05)U,住院时间(12.23±3.84)d。操作过程中未见输血反应及肉眼血尿,且无血液污染现象。结论 ANH联合回收式自体输血不仅可解决血源短缺问题,还能避免疾病传播、异体输血反应,应用于心脏瓣膜置换术安全有效。
Objective To analyze and discuss the experience of using acute isovolumetric hemodilution ANH combined with recovery autologous blood transfusion during heart valve replacement. Methods 50 patients who underwent cardiac valve replacement in the hospital from June 2018 to June 2019 were selected. ANH was maintained after anesthesia was maintained. After treatment, purified and concentrated red blood cells were collected and returned to patients for observation. The average blood collection volume, intraoperative blood loss volume, recovery autologous blood transfusion volume, fluid replacement volume, 1 h postoperative drainage volume, allogeneic plasma transfusion volume, and length of hospital stay, were there any transfusion reactions, gross hematuria, and blood contamination during the procedure. Results The vital signs during the operation were stable, the average blood volume was(392.37 ±45.65) m L, the intraoperative blood loss was(845.39 ± 56.76) mL, the recovery autotransfusion volume was(596.45 ±75.21) mL, and the fluid replacement volume was(1029.73 ± 205.21) mL. The drainage volume(32.76 ± 10.57) m L,the amount of allogeneic plasma transfusion(1.64 ± 1.05) U, and the length of hospital stay(12.23 ± 3.84)d at 1 hour after operation. No blood transfusion reaction and gross hematuria were observed during the operation, and there was no blood pollution. Conclusion ANH combined with autologous blood transfusion can not only solve the problem of blood source shortage, but also avoid disease transmission and allogeneic transfusion reaction. It is safe and effective for heart valve replacement.
作者
张帮健
邓若敏
杨昶
ZHANG Bang-jian;DENG Ruo-min;YANG Chang(Department of Anesthesiology,Panzhihua Central Hospital,Panzhihua,Sichuan Province,617000 China)
出处
《系统医学》
2020年第5期52-54,共3页
Systems Medicine
