自体血液回输与异体血输注对机体红细胞恢复的影响

目的 研究自体血液回输与异体血输注对机体红细胞恢复的影响.方法 选择择期手术患者,术中单纯自体血回输和同期单纯输注异体血两组患者进行比较,回顾性分析其临床输血诊疗过程,动态追踪机体血常规变化,评估输血纠正贫血疗效.结果 术中使用自体血液回输19例,自体血液回输400～1000ml(平均680ml).术中输注异体血液的15例,输注红细胞2～9U(平均5U);两组之间术前、术后1天、7天、14天红细胞计数、血细胞比容、血红蛋白差异均无显著性,但术后21天出现显著差异,自体血液回输组患者红细胞增长更快.结论 与异体血输注比较,自体血回输不但具有安全、无传染病、不产生对血液成分的免疫反应等优点,更有利于机体红细胞恢复.     

自体血回输在骨科择期手术中的护理和应用

目的探讨术中自体血回输技术在骨科择期手术中的护理和应用。方法将93例行骨科择期手术的患者随机分为两组试验组（51例）和对照组（42例）。试验组术中采用自体血回输技术,对照组术中采用常规异体输血。对比两组患者手术前及术后1 d的RBC、HGB、HCT、PLT凝血五项各指标。结果试验组患者均成功完成手术,术中及术后不需输注库存异体血,未发生输血反应及并发症;对照组患者输血后有3例发生并发症,其中全身皮疹1例,寒战高热2例。结论自体血回输可使需输血的骨科手术患者避免了异体输血带来的潜在危险,且并发症少。     

自体血回输在骨科择期手术中的护理和应用

目的探讨术中自体血回输技术在骨科择期手术中的护理和应用。方法将93例行骨科择期手术的患者随机分为两组试验组(51例)和对照组(42例)。试验组术中采用自体血回输技术,对照组术中采用常规异体输血。对比两组患者手术前及术后1 d的RBC、HGB、HCT、PLT凝血五项各指标。结果试验组患者均成功完成手术,术中及术后不需输注库存异体血,未发生输血反应及并发症;对照组患者输血后有3例发生并发症,其中全身皮疹1例,寒战高热2例。结论自体血回输可使需输血的骨科手术患者避免了异体输血带来的潜在危险,且并发症少。     

Rh(D)阴性患者自体输血的临床分析(附29例报告)

目的探讨择期手术的Rh(D)阴性患者进行自体输血的临床意义.方法对确定为Rh(D)阴性血型的29例择期手术患者即与临床医生联系并决定行自体输血.患者口服多糖铁150mg,每日2次.按预计患者术中输血量,分次进行采血,每次采血400ml,间隔3d进行第二次采血.为了缩短手术等待的时间,最后一次采血在手术中进行.结果29例患者有7例术前采自体血400ml(24.1%);21例术前采自体血800ml,同时术中回收自体红细胞300ml(72.4%);1例术前采自体血800ml,术中回收自体红细胞300ml,另外输注异体悬浮红细胞260ml(3.5%).结论在Rh(D)阴性血液紧张的情况下应用术前自体储血的同时配合术中血液回收术,90%以上的患者均可避免输异体血.     

骨科重大手术术中自体血回输的护理

目的探讨骨科重大手术术中自体血回输的护理要点。方法对2009年6月-2011年6月间收治的40例骨科重大手术术中使用自体2000型血液回收机,进行术中自体红细胞回输的护理要点进行分析讨论。结果 40例患者术中总出血量57 650 ml,回收32 572 ml,平均每例回收814 ml,有5例输入异体浓缩红细胞400～2000 ml。所有回收的洗涤红细胞于术中回输给病人,护理操作过程中未发生一例血液污染现象。40例患者术后顺利恢复,未见回输血不良反应。结论在当前血源紧张的情况下,骨科一些重大手术采用血液回收机将术中出血进行回收然后回输,达到了充分利用自身血,节约血源,减少异体输血不良反应的目的。     

185例自体输血在骨科手术中的应用及临床效果观察

目的 :观察自体输血在骨科手术中的应用及临床效果。方法 :185例骨科手术患者应用自体输血技术 ,术前均采用预存自体血 ,其中 4 9例加用术中出血回收红细胞洗涤后回输 ,5 6例加用术后伤口引流血回输。观察患者术前、术中、术后各项相关指标变化。结果 :本组 173例靠自体输血顺利完成手术 ,12例加用异体输血。其用血量较以往同类手术明显减少 ,自体输血未发现不良反应。结论 :自体输血安全有效 ,节约血源 ,减少异体输血的潜在风险。     

洗涤式自体血回输技术在骨外科手术中的应用及护理对策

目的：探讨洗涤式自体血回输技术在骨科手术中的应用和护理对策。方法骨科手术患者63例,施行手术时应用京精自体血液回收机回收术中血液,经处理后形成浓缩红细胞回输给患者,在治疗过程中实施术前护理、术中护理、术后病情观察及随访。结果63例患者,术中回输血量500～1800 ml,平均650 ml;所有患者均无输血反应,无过敏、溶血、感染等并发症;术后复查血常规、凝血功能、电解质和尿常规结果正常。均不需输入异体血。结论骨科手术中应用洗涤式自体血回输效果好、安全,细致的护理是手术成功的关键。     

术中出血回输在骨科手术中的应用

目的 :为了解决血源紧张及异体输血的危害 ,探讨应用 2 0 0 0型血液回收机行术中出血回输在骨科手术中的应用。方法 :自 1999年 11月～ 2 0 0 1年 11月 ,对 5 0例骨科择期手术患者采用了术中出血回输方法 ,同期选择 5 0例类似患者采用术中输异体血作为对照。结果 :自体输血组显著减少输异体血量 ,但是 4 6 %患者仍然需要补充异体血。光镜观察回收处理后红细胞形态正常、无碎片。回收血培养均呈阴性。手术后第 1天患者红细胞、Hb、HCT均明显低于手术前 ,但是未见明显失血反应表现 ,术后 1周恢复正常。电解质术前、术后无异常。异体输血患者有 8例发生输血反应。结论 :骨科手术中使用血液回收机进行自体输血值得推广 ,但是不能完全取代异体输血。     

自体血回收仪在脑瘤手术患者中的应用

目的探讨应用自体血回收仪减少输血量和输血并发症的可能性。方法采用自体血回收仪对30例选择性脑瘤手术患者的手术出血进行洗涤回输。结果观察组30例患者自体血回输量（560±72）ml，输异体血（260±48）ml,无自体血回输并发症。对照组输异体血（491±78）ml明显高于观察组（160±48）ml，P〈0．01。结论应用自体血回收仪，可减少脑瘤手术中的出血输血量和输血并发症，尤其适合估计术中出血较多的大手术.     

不同自体输血技术在单侧初次髋关节置换术的应用体会

目的 探讨几种自体输血方法在单侧初次人工全髋关节置换围手术期的作用和临床意义.方法 将118例单侧初次全髋关节置换病人按使用自体血回输方法不同分成5组,分别为(1)未使用自体血组19例.(2)单纯使用术前预存自体血组(术前预存组)27例.(3)单纯使用术中血液回输组(术中回输组)28例.(4)术前预存自体血结合术中血液回输组(术前中组)34例.(5)联合使用术前预存自体血、术中血液回输及术后引流血回输组(术前中后组)共10例.分析各组患者在围手术期输异体血比例和输血量方面有无统计学差异.结果 未使用自体血组,64.8%(13/19)输异体血浆平均140ml;89.5%(17/19)输异体压积红细胞平均460ml.术前预存组,14.8%(4/27)输血浆平均61.5ml,14.8%(4/27)输压积红平均61.5ml.术中回输组,78.6%(22/28)输血浆平均192.9ml,85.7%(24/28)输压积红平均278.6ml.术前中组,11.8%(4/34)输血浆平均23.5ml,11.8%(4/34))输压积红平均35.3ml.术前中后组无一例输异体血液(0/10).未用自体血组与术中回输组在输血例数与输血量方面差异无显著性,而这两组与其他三组比较差异有显著性.结论 1、单纯使用术中自体血回输在单侧初次髋关节置换手术中应用未能有效减少异体血液的输入.2、联合使用术前预存自体血、术中血液回输及术后引流血回输三种方法,在单侧初次髋关节置换手术中应用能最大限度的减少异体血液的输入.3、综合各种因素分析在单髋初次置换病例中,术前预存自体血技术最为经济,同时又可减少患者输入异体血的机会.     

Autologous versus allogeneic transfusion: patients'' perceptions and experiences

BACKGROUND: Preoperative autologous donation is one way to decrease a patient's exposure to allogeneic blood transfusion. This study was designed to determine patients' perceptions about the autologous blood donation process and their experiences with transfusion. METHODS: To assess patient perception, a questionnaire was administered a few days before surgery to patients undergoing elective cardiac and orthopedic surgery in a Canadian teaching hospital. All patients attending the preoperative autologous donation clinic during a 10-month period were eligible. A convenience sample of patients undergoing the same types of surgery who had not predonated blood were selected from preadmission clinics. Patient charts were reviewed retrospectively to assess actual transfusion practice in all cases. RESULTS: A total of 80 patients underwent cardiac surgery (40 autologous donors, 40 nondonors) and 73 underwent orthopedic surgery (38 autologous donors, 35 nondonors). Of the autologous donors, 75 (96%) attended all scheduled donation appointments, 73 (93%) said that they were "very likely" or "likely" to predonate again, and 75 (96%) said that they would recommend autologous donation to others. There was little difference in preoperative symptoms between the autologous donors and the nondonors, although the former were more likely than the latter to report that their overall health had remained the same during the month before surgery (30 [75%] v. 21 [52%] for the cardiac surgery patients and 30 [79%] v. 18 [51%] for the orthopedic surgery patients). When the autologous donors were asked what they felt their chances would have been of receiving at least one allogeneic blood transfusion had they not predonated, the median response was 80%. When they were asked what their chances were after predonating their own blood, the median response was 0%. The autologous donors were significantly less likely to receive allogeneic blood transfusions (6 [15%] for cardiac surgery and 3 [8%] for orthopedic surgery) than were the nondonors (14 [35%] for cardiac surgery and 16 [46%] for orthopaedic surgery). They were, however, more likely to receive any transfusion (autologous or allogeneic) than were the nondonors (25 [63%] v. 14 [35%] for cardiac surgery and 31 [81%] v. 16 [46%] for orthopedic surgery). INTERPRETATION: Patients who underwent preoperative autologous blood donation were positive about the experience and did not report more symptoms than patients who did not donate blood preoperatively. Autologous donors overestimated their chances of receiving allogeneic blood transfusions had they not predonated and underestimated their chances after they had predonated. They were less likely to receive allogeneic transfusions, but more likely to receive any type of transfusion, than were patients who did not predonate.     

术中自体血回输在骨科手术中的应用价值

目的探讨自体血回输在骨科手术中的应用价值。方法对50例骨科患者采用京精Z-2000A血液回输机进行自体血回输,并对患者手术前、后血红蛋白、红细胞压积（HCT）、血小板、活化部分凝血酶时间（APTT）等进行分析。结果 50例患者术中出血总量75400 ml,自体血回输40750 ml,其中49例患者无自体血回输并发症发生,1例发生DIC。结论回收式自体血液回输可有效减少骨科大手术中血液丢失,减少输注异体血,是一种经济、安全、实用的血液保护技术。     

预存自体输血在外科手术中的应用

目的探讨外科手术减少异体输血的措施 ,介绍一种较理想的自体输血方法。方法自 2 0 0 0年 12月至 2 0 0 3年 1月 ,对我院 6 5例接受外科手术患者进行了预存自体输血。男 4 2例 ,女 2 3例 ,年龄 2 0岁～ 6 8岁 ,平均 5 2 .7岁。骨科手术 32例 ,胸外科手术 19例 ,普外科手术 14例。采血前、采血后第 7天检测血红蛋白 (HGB)、红细胞 (RBC)、红细胞压积 (HCT)。结果 4 2例(6 4 .6 % )完成一次采血 ,2 0例 (30 .8% )完成两次采血 ,3例 (4 .6 % )完成三次采血。预存自体血 31135ml,平均 4 79ml。 5 1例(78.5 % )患者无需异体输血顺利度过围手术期 ,14例 (2 1.5 % )患者补充异体输血 4 4 6 6ml,平均 319ml。没有发生与预存自体输血相关的并发症。结论预存自体输血简便、经济、安全、有效 ,是解决血源紧张较理想的方法之一。     

预自血回输在使用止血带的长时间下肢骨科手术中的意义

目的：探讨预自血回输在使用止血带的长时间下肢骨科手术中的意义。方法选择下肢骨科创伤拟行手术治疗的患者60例,随机数字表法分成常规组（30例）和预自血回输组（30例）,均采用腰硬联合阻滞麻醉与止血带,预自血回输组患者在术中给予京精3000P型血液回收机作自血回收处理,常规组则尽量减少放止血带时的出血,必要时才给予异体输血。比较两组患者的手术时间、术中出血量、输血率及输血量（包括术后异体输血）、有无输血反应以及术前30min、术后180min、术后第1天的血红蛋白（Hb）含量。结果预自血回输组的术中自血回输量多于常规组的异体输血量,差异有统计学意义（P＜0.05）,常规组术后异体输血率高于预自血回输组,差异有统计学意义（P＜0.01）;预自血回输组术后第1天Hb含量高于常规组,差异有统计学意义（P＜0.05）。结论预自血回输在使用止血带的长时间下肢骨科手术中有较好的血液保护作用,能有效提高患者Hb含量,明显减少患者术中与术后异体输血的概率。     

洗涤式自体血回输在心脏外科手术中的应用研究

目的探讨自体血回输在心脏外科手术中的应用价值。方法对50例手术患者采用京精Z-2000A血液回输机进行洗涤式自体血回输,并对患者手术前、后血红蛋白、红细胞压积（HCT）、血小板、活化部分凝血酶时间（APTT）等进行分析。结果50例患者术中回收原血66352 ml,经回收机处理后每例患者获得洗涤后浓缩红细胞为855 ml。所有患者无一例回输血过程中出现寒战、发热、溶血等不良反应。结论回收式自体血液回输可有效减少心脏外科大手术中血液丢失,减少异体血输注量,特别是在经济落后以及爱滋病、传染病高发地区更有临床意义。     

Transfusion practices among patients who did and did not predonate autologous blood before elective cardiac surgery

BACKGROUND: Preoperative autologous blood donation is commonly used to reduce exposure to allogeneic transfusions among patients undergoing elective cardiac surgery. However, this technique is associated with an overall increase in transfusions (allogeneic or autologous). The authors assessed the impact of transfusion decision-making on the effectiveness of preoperative autologous donation in reducing the frequency of allogeneic transfusions, and its impact on the increased transfusion rate associated with preoperative autologous donation in cardiac surgery. METHODS: This retrospective analysis compared transfusion practices among 176 patients who predonated autologous blood before elective cardiac surgery and 176 matched cardiac surgery patients who did not predonate blood. The impact of decision-making on transfusion exposure was determined using multivariate analyses to account for major perioperative interventions and complications. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for exposure to allogeneic blood transfusion or any transfusion, before and after exclusion of transfusions not conforming with selected transfusion criteria. RESULTS: Exposure to allogeneic transfusion was more likely among patients who did not predonate blood than among those who did predonate blood (OR 14.0, 95% CI 5.8-33.8). This finding was still true after exclusion of transfusions not meeting the transfusion criteria (OR 19.3, 95% CI 6.7-55.7). The autologous blood donors were more likely than the nondonors to receive any transfusion (OR 10.8, 95% CI 5.7-20.3). However, this association was substantially attenuated after exclusion of transfusions not meeting the transfusion criteria (OR 1.9, 95% CI 1.1-3.2). INTERPRETATION: Patients who predonated blood before elective cardiac surgery were at lower risk of receiving allogeneic transfusions than the nondonors. This was not because of a deliberate withholding of allogeneic transfusions from autologous donors. However, more liberal transfusion criteria for autologous blood were largely responsible for the increased transfusion rate among the autologous donors.     

储存式自体血回输在心脏瓣膜置换术中的应用研究

目的 探讨储存式自体血回输在心脏瓣膜置换术中的应用价值.方法 对38例择期行心脏瓣膜置换术患者术前储存自体血200 ～ 600 ml,分析采血前、后及输入自体血后患者血常规和血凝分析实验室数据变化情况,统计输血不良反应、节约血量等.结果 采血前后各项血液指标差异无统计学意义（P＞0.05）.手术回输血后各项指标与手术前比较除血小板、PT、APTT无明显变化（P＞0.05）,HB、HCT、RBC低于术前（P＜0.01）,但位于正常参考值范围内,不会造成组织缺氧,避免输异体血率为47.37％（18/38）;所有患者在回输血过程中无不良输血反应.结论 储存式自体血回输安全有效,可以部分解决心脏瓣膜置换术的输血要求,减少异体血输血量,具有很好的临床应用价值.     

储存式自体输血在外科手术中的应用

目的通过临床观察,探讨储存式自体输血在妊娠晚期孕妇和全髋、膝关节置换术、腰椎间盘突出手术患者中的应用。方法对40例已接受储存式自体输血的患者资料进行回顾性分析。结果 10名妊娠晚期孕妇血液成分采集后与分娩后血液成分WBC、RBC、Hb、Hct存在差异,可能与分娩时出血和组织损伤有关。30名全髋、膝关节置换术、腰椎间盘突出手术患者对照组（输入异体血患者）和自体输血组各自术前、术后3日比较WBC、RBC、Hb、Hct、Plt差异较大,有统计学意义。自体采血组,采集前、后WBC、RBC、Hb、Hct差异较大,但在正常范围。而输入异体血患者和输入自体血患者术后3日比较无差异。并且输入自体血患者住院天数少于异体血患者。结论妊娠晚期和全髋、膝关节置换术、腰椎间盘突出手术患者采用储存式自体输血是安全有效可行的,在血液供应紧张的今天,储存式自体输血应大力推广。     

自体血液回输在腰椎手术中的应用

目的探讨自体血液回输在腰椎手术中的应用情况。方法应用国产自体2000型血液回输机对30例腰椎手术患者进行术中血液回输,同时对患者术前及术后进行血常规、血清电解质检查。结果通过血常规测定,红细胞回收率90%以上,全部病例术后恢复顺利,无输血反应及感染,血液回收效果良好。异体输血回避率100%,手术前后血清电解质无明显改变。结论腰椎手术中失血量较多,应用自体血液回输能有效减少自体血丢失和异体血输入,既节约血液,又可减少异体输血的不良后果。     

Effects of intraoperative autologous blood donation and tepid temperature cardiopulmonary bypass on blood system

We have reported previously that routine cardiopulmonary bypass (CPB) causes platelet count reduced and platelet function h....dlil. Modificationsto routine CPB should be made in order to reduce theharmful non--physiological low temperatUre of CPB tothe blood system and reduce postoperative non--surgical bleeding and blood transfusion needed. The present clinical experiment was designed to investigateintraoperative autologous blood donation and tepidtemperature CPB and compared with routi…