滚压泵长时间转流对红细胞脆性度和形态学的影响

为了解滚压泵长时间转流对红细胞脆性度和形态学的影响。我们采用 2种滚压泵 Polystan小儿泵 (A组 )和 COBE泵 (B组 )分两组作 5次、每次 16 h离体转流实验。测定项目 :红细胞脆性度、红细胞电镜扫描观察和游离血红蛋白测定。血标本为转前、转中 4h后每隔 2 h抽血标本 ;电镜标本为转前、转中每隔 4h抽一次。结果 :1、两组红细胞脆性度各时点的数值与其前一时点比较 ,没有差别。 2、电镜标本 :转前、转中 4、8、12、16 h标本中 ,每百个红细胞中棘球红细胞数 A,B两组分别为 :1.77± 0 .83,1.81± 0 .78;6 .12± 1.12 ,7.13± 1.2 5 ;9.18± 1.0 7,8.73±1.16 ;13.2 1± 1.32 ,12 .89± 1.5 3;16 .5 3± 1.2 4,17.2 1± 1.34。各时点与其前一时点值比较 ,有显著差异 (P <0 .0 5 )。两组均可见到各种变形红细胞。 3、两组游离血红蛋白 :随转流时间延长而呈线性不断增多。两组溶血指数分别为 0 .2 96 m g/ L / h和 0 .3993mg/ L / h。实验结果表明 :1、滚压泵长时间转流不会引起红细胞脆性度增加 ;2、滚压泵的挤压可致红细胞膜的直接损伤和破裂 ;3、红细胞形态学的改变是导致术后延迟性溶血的基础

The Study of Erythrocyte Fragility and Morphological Changes Caused by Roller Pump in vitro

To observe the erythrocyte fragility and morphological changes of erythrocytes caused by roller pump. Ten tests were divided into two groups,Polystan pediatric pump group A (n=5)and COBE pump group B(n=5). Ten whole blood samples (each 400 ml) were circlulated in the roller pump for 16 h. Erythrocyte fragility and free hemoglobin were measured before pumping and at every 2 hours during pumping. The possible morphological changes of erythrocytes caused by roller pump were observed by scanning electron microscope. The electron microscopic observation was made before pumping and at every 4 hours throughout pumping. Results showed that the erythrocyte fragility of two groups was not increased during a long period of pumping. The number of acanthocytes of two groups was 1.77/1.81% in the samples before pumping and 6.12/7.13, 9.18/8.73, 13.21/12.89, 16.53/17.21% at 4 h, 8 h, 12 h,and 16 h respectively. The free hemoglobin level of two groups was increased linearly during a long duration of pumping and the index of hemolysis of two groups was 0.296 mg/L/h and 0.3993 mg/L/h respectively.The result shows: 1.the erythrocyte fragility was not increased during a long period of pumping; 2. the erythrocyte membrane was injured or broken by roller pump directely; 3.the morphological changes of erythrocytes would be the basis of post operative hemolysis.