异体与术中回收式自体输血对凝血功能影响的比较

目的 观察术中回收式自体输血后凝血状态的变化。方法36例择期行骨科大手术病人,将同性别,手术类型及年龄相近的两位病人配为一对,随机分配到回收式自体输血组(试验组)或异体输血组(对照组)中。试验组用血液回收仪回收术中出血,经过滤、离心、清洗后回输给病人。分别取术前、输血前、输血后1h及术后24h的静脉血,测定血常规、凝血酶原时间(PT)、部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT),同时用血栓弹性描记仪测定血栓弹性描记图(Thrombelastography,TEG)的各项指标。结果 试验组稀释后Hb明显低于对照组(P<0.05)。血常规其余各值、PT、APTT、FIB及TT在各测定点两组变化一致,两组间均无显著差异(P>0.05);试验组R在稀释后明显延长(P<0.05),但与对照组比差异不显著。两组间TEG其它各项指标在各测定点亦差异不显著(P>0.05)。结论 回收式自体输血与异体输血相比对凝血状态的影响差异不显著。     

肝移植术麻醉中自体血液回输技术的应用

目的 探讨肝移植术中应用自体血液同输技术的安伞性和效果.方法 选择行原化肝移植术患者46例,根据是否符合自体血回输标准分为两组:回输组和对照组,每组23例.回输组术中应用自体血液回收机进行血液收集、回输,观察其效果.分别于麻醉前、无肝前期、无肝期、新肝期、术毕等时点采血样,测定红细胞汁数(RBC)、血红蛋白(Hb)、血小板(Plt)、血细胞比容(Hct)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原含量(FIB)及国际标准化比值(INR).结果 回输组每例回输自体血(2 613±1 637)ml,输入异体浓缩红细胞量显著少于对照组(P＜0.01),两组间各时点RBC、Hb,Plt、Hct、PT、APTT、FIB、INR差异无统计学意义.结论 肝移植术中应用自体血液叫输技术能及时回收失血,维持有效循环,显著减少异体血输入.     

预贮式自体输血和急性等容性血液稀释联合应用于颅脑外科手术的临床研究

目的 探讨在颅脑外科手术中联合应用预贮式自体输血和急性等容性血液稀释的安全性和临床效果。方法 63例病人随机分为预贮式自体输血组(A组31例)和联合应用预贮式自体输血和急性等容性血液稀释组(B组32例)。两组在采血前、术前即刻放血前、放血后、回输自体血后、术后第1天分别测定Hb、Hct、Pt及PT、APTT、FIB，监测MAP、CVP、SpO2、HR，两组出血量、输异体血量。结果 A、B组Hb、Hct术中降低，与术前比较有显著性差异(P＜0．05)，回输自体血后回升。A、B两组PT、APTT术中延长，FIB和Pt未见明显改变。两组术中血流动力学稳定。A组采血量明显少于B组(P＜0．05)，输异体血量明显多于B组（P＜0．05)。结论 联合应用预贮式自体输血和急性等容性血液稀释有明显节血效应，对血液生理学影响小，血流动力学稳定。     

自体血回输对病人血浆肝素含量的影响

目的　观察自体血回输对病人血浆中肝素含量的影响 ,探讨肝素在血液回收时的应用。方法　自体血液回输组 (n =32 )与异体输血组 (n =30 )骨科、脑科择期手术病人 ,男女各半 ,年龄 18～ 48岁 ,术前肝、肾、凝血功能均正常 ,无其他血液系统疾病。自体回输血量及异体输血量均超过 10 0 0ml。采用凝固法测定血浆中肝素含量 ;ACT Ⅱ型测定仪测定血中活化凝血时间 (ACT)。结果肝素含量 :自体血液回输组 ,术前、输血前、输血后 2小时肝素含量分别为 (0 6 5± 0 2 7)、(0 6 8±0 2 0 )和 (0 72± 0 19)U/ml;异体输血组分别为 (0 6 3± 0 2 4)、(0 6 7± 0 2 8)和 (0 6 9± 0 2 0 )U/ml。两组间均无显著差异 (P >0 0 5 )。ACT :自体血回输组三个不同时间分别为 (86 10± 2 0 5 4)、(133 5 0± 2 9 6 5 )和 (95 0 5± 2 9 71)秒 ;异体输血组分别为 (88 42± 18 37)、(131 70± 2 7 36 )和(92 86± 14 35 )秒。两组ACT值输血前均明显长于术前 (P <0 0 5 ) ,术前与输血后 2小时无显著差异 (P >0 0 5 )。结论　自体血液回输组与异体输血组术前、输血前、输血后 2小时肝素含量无显著差异。自体血回输中使用肝素抗凝适量 ,安全可行     

限制性输血在全膝关节置换患者术后的应用

目的探讨严格输血指征(Hb80 g/L)结合自体引流血回输的限制性输血在TKA患者术后应用的安全性和有效性。方法选取自2013-03—2014-12行单侧TKA的骨性关节炎120例,随机分为A组(Hb100 g/L时输血);B组(Hb80 g/L时输血);C组(Hb80 g/L时输血结合自体引流血回输)。观察记录各组手术时间、出血量、术后引流血量、回输血量、输注异体血量和输血不良反应例数;术前、术后2 d、5 d、出院时Hb、红细胞压积(Hct)、血浆凝血酶原时间测定(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-Dimer)检测值。结果 C组回输引流血(330.5±61.4)ml,输异体血(70.0±195.1)ml,异体血输注率12.5%,低于B组和A组,差异有统计学意义(P0.05)。手术时间、术中失血量、术后引流量及输血不良反应率与B组和A组相比较差异无统计学意义(P0.05)。结论限制性输血对TKA患者是安全的,在达到预期手术治疗效果的同时,有效减少或杜绝了输注异体血的风险。     

控制性降压联合自体血回输在脊柱手术中的应用

目的 探讨控制性降压联合自体血回输技术应用于复杂脊柱外科大手术的临床效果及安全性. 方法 将40例脊柱外科大手术的患者用抽签法随机分为两组(每组20例):控制性降压联合自体血回输组(A组)和非自体血回输组(B组).A组全麻诱导后,术中用硝酸甘油行控制性降压,维持平均动脉压(mean arterial pressure,MAP)(65±5) mmHg(1mmHg=0.133 kPa),并用血液回输仪回收术野出血;B组未行自体血回输;两组术中血细胞比容(hematocrit,Hct)低于25％即输库血.两组术中连续监测心率(heart rate,HR)、MAP、心电图(electrocardiogram,ECG)和中心静脉压(central venous pressure,CVP).记录两组患者术中出血量、异体输血量及输血相关并发症,术前和术后24 h红细胞(red blood cell,RBC)、血红蛋白(hemoglobin,Hb)、Hct、血小板(platelet,PLT)及凝血酶原时间(prothrombintime,PT)、活化部分凝血酶原时间(activeated partial thromboplasting time,APTT)和纤维蛋白原(fibrinogen,FG). 结果 A组出血量(1 120±510) ml与B组(1 524±457) ml比较,差异有统计学意义(P＜0.05);A组输异体血发生率(10％)显著少于B组(100％)(P＜0.01);术后24 h两组患者RBC、Hb、Hct、PLT、PT、APTT和FG与术前比较差异有统计学意义(P＜0.05),但都在正常范围内,两组间比较差异无统计学意义(P＞0.05);两组均无肺水肿、心力衰竭及创面异常出血并发症. 结论 控制性降压复合术中自体血回输在复杂脊柱手术中的应用是安全可靠的,能明显减少出血量,减少甚至避免异体血输入.     

三种输血方式对骨科手术患者术中输血的效果比较

目的 探讨三种输血方式在骨科手术患者术中输血中的临床应用效果。方法 回顾性选定2020年1月到2023年1月在本院收治的行骨科手术的患者99例作为研究对象。根据不同输血方式分为三组，每组各33例，其中A组采用急性等容性血液稀释（ANH）联合术中自体回收式输血方式，B组采用自体回收式输血方式，C组采用异体输血方式。比较三组血常规[血红蛋白（Hb）、红细胞计数（RBC）、红细胞压积（HCT）、血小板计数（PLT）]；比较两组凝血功能状况[凝血酶原时间（PT）、部分激活凝血活酶时间（APTT）、纤维蛋白原（FIB）]；比较三组输血不良反应发生情况。结果 术前，三组患者血常规比较无明显差异（P>0.05），术后，三组患者Hb、RBC、HCT、PLT均降低，且术后各指标组间比较A组>B组>C组，差异有统计学意义（P<0.05）。术前，三组患者凝血功能比较无明显差异（P>0.05），术后，三组患者PT、APTT、FIB均提升，但术后PT、APTT组间比较A组明显小于B、C组（P<0.05）;B、C组两组PT、APTT比较差异无统计学意义（P>0.05）;A...     

髋关节手术应用自体血回收技术的效果分析

背景：自体血回输可有效提供相容性血细胞,及时补充血容量,减少异体血输入量,降低异体输血的并发症,对机体的凝血功能无不良影响,因而越来越受到人们的重视。目前,有关髋关节手术应用该技术的临床研究甚少。 目的：观察髋关节手术中自体血回输技术（IOCS）的临床应用效果。 方法：选择40例髋关节手术患者,随机分为自体血回输组（实验组）20例和输注异体血组（对照组）20例。观察不同时段血常规、凝血时间的变化以及并发症发生情况。 结果：实验组比对照组共节约库存用血约8000 ml。A组患者自体血回输即刻与术前相比血红蛋白（Hb）降低,但很快恢复正常,4 d后红细胞计数（RBC）、Hb、红细胞压积（Hct）与术前相比无统计学差异。血小板计数（PLT）及凝血酶原时间（PT）与术前相比有统计学差异（P＜0.05）,与B组相比无统计学差异（P＞0.05）。 结论：IOCS是一种安全有效的节约用血方法,适合在骨科髋关节手术中推广。     

洗涤回收式自体输血对腹部创伤患者细胞免疫的影响

目的:探讨洗涤回收式自体输血对腹部创伤患者细胞免疫的影响。方法:2006年6月—2011年5月收治需手术治疗并输血的腹部创伤患者共386名。应用随机数字法将患者分为2组,每组193例。研究组采用洗涤回收式自体输血,对照组用同种异体输血。记录腹部创伤患者急救期的回收血量、洗涤血量和回输血量,分别监测其输血前、输血后1 h及输血后24 h生命体征和凝血功能指标的动态变化;输血前、输血后24 h及输血后5 d T细胞亚群和细胞因子的变化。结果:研究组193例患者腹腔内积血和术中出血全部回收和回输成功,患者术中平均回收血量(2 196±620)mL,平均洗涤红细胞悬液量(5 172±615)mL,回收率为89.3%。对照组193例患者输血量400-2 200 mL,平均(910+276)mL。2组患者术中和术后生命体征平稳,研究组和对照组各项监护指标值的组间差异无统计学意义(P>0.05)。术后对照组CD8+、CD4+/CD8+显著减少,研究组CD8+、CD4+/CD8+也有所减少,但减少幅度小于对照组,组间差异有统计学意义(P<0.05)。术后2组患者IL-6、IL-8均升高,但研究组与术前比差异有显著性,对照组与术前相比较差异无统计学意义(P>0.05)。术后2组患者IL-6、IL-8组间差异有统计学意义(P<0.05)。结论:洗涤回收式自体输血对腹部创伤患者免疫功能影响小,值得临床进一步研究并推广。     

多种血液保护方法在骨科围术期的联合应用

目的观察联合多种技术手段、药物对骨科手术患者失血、凝血功能和血液氧合状态的影响以及实施血液保护的效果。方法选择2013年2月至2014年1月在我院就诊的271例骨科手术治疗患者,术前行储存式自体输血,术中采用控制性降压技术、稀释式或回收式自体输血技术,并使用凝血药物等;观察患者手术前后血红蛋白(hemoglobin,Hb)、红细胞比容(red blood cell specific volume,Hct)、血小板计数(blood platelets count,BPC)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、血浆黏度、全血黏度以及混合静脉血氧分压(mixed venous blood oxygen tension,PvO2)、混合静脉血氧饱和度(mixed venous oxygen saturation,SvO2)等指标的变化,对比分析实施血液保护对患者贫血程度、凝血功能、血液流变学以及血液氧合状态的影响。结果本组病例围术期自体输血共179 010 mL,异体输血共35 000 mL,未出现输血不良反应;患者术后Hb、Hct、BPC、血浆黏度、全血黏度均低于术前,差异均有统计学意义(均P<0.05),PvO2、SvO2较术前有所升高,但差异均无统计学意义(均P>0.05),APTT、PT手术前后无明显变化,差异均无统计学意义(均P>0.05)。结论骨科围术期联合应用多种血液保护方法能明显减少失血,减少异体输血,保护血液资源,且未对患者凝血功能、氧合状态产生明显影响。     

Möglichkeiten und Grenzen der intraoperativen maschinellen Autotransfusion (MAT) bei radikalen Prostatektomien

Intraoperative autotransfusion (MAT), preoperative autologous blood donation, and preoperative normovolaemic haemodilution are three different methods to avoid homologous blood transfusion during surgical procedures. The controversial use of MAT via cell saver in tumour surgery as well as contamination of the operative field with urine illustrate the particular difficulties of autologous blood transfusion in connection with radical prostatectomy. We investigated changes in the osmotic resistance of the retransfused red blood cells (RBC), bacterial contamination, changes in coagulation parameters, and the presence of tumour cells. Patients and methods: After written informed consent, 24 patients who presented for radical prostatectomy were randomly allocated to either a group that used MAT or a group that used homologous transfusion. The patients received ?balanced anaesthesia” with midazolam, fentanyl, atracurium, and nitrous oxide/oxygen. The analysed parameters from the preoperative period to the 3rd postoperative day are shown in Table?1. The Haemonetics 3 Plus Cell Saver was used for autotransfusion. Results: Our results showed that the haematologic parameters, coagulation factors, and serum chemistry did not differ between the two groups (Tables?2–4). However, there were significant differences during the investigated period. The osmotic resistance of the salvaged RBCs was higher than that preoperatively. Furthermore, there were no tumour cells in the autologous salvaged RBCs. Conclusion: Our results showed no decrease in the quality of the autotransfused RBCs, urine was not retransfused; and there were no significant differences between the groups postoperatively. Although there were no tumour cells in the salvaged blood, the possibility of blood irradiation is discussed. We concluded that because of the risk of infection of homologous blood products, MAT is a safe possibility to reduce the amount of homologous blood transfusion required in connection with radical prostatectomy.     

Intraoperative autotransfusion in primary hip arthroplasty. A randomized comparison with homologous blood.

To study the quality and effect of blood produced by the cell saver compared with homologous blood in total hip arthroplasty, 40 patients were randomly divided into two groups. One group received autologous blood using the cell saver, whereas the second group served as a control, and received homologous bank blood. Hematologic and coagulation parameters of the patients were assessed both preoperatively and postoperatively. Samples from the autologous and the homologous blood were obtained before reinfusion, and were assessed as regards hematologic and biochemical parameters. The autologous blood satisfied all the intraoperative transfusion requirements of the autologous group and 75 percent of the total transfusion requirements. The operative and postoperative blood losses--hence, the total blood loss--were less in the autologous than in the control group. The autologous blood had a high hemoglobin, white blood cell, and plasma hemoglobin content and MCV compared with the homologous blood. Postoperatively, there were no differences as regards the hematologic parameters studied. There was no evidence of intravascular hemolysis in the autologous group. Postoperatively, in both groups, AT III, plasminogen, and protein C decreased. Other coagulation parameters were within normal limits in both groups. Intraoperative autotransfusion is safe and effective, and should be considered in hip arthroplasty to reduce the risks associated with homologous blood transfusion.     

Intraoperative autotransfusion in primary hip arthroplasty: A randomized comparison with homologous blood

To study the quality and effect of blood produced by the cell saver compared with homologous blood in total hip arthroplasty, 40 patients were randomly divided into two groups. One group received autologous blood using the cell saver, whereas the second group served as a control, and received homologous bank blood. Hematologic and coagulation parameters of the patients were assessed both preoperatively and postoperatively. Samples from the autologous and the homologous blood were obtained before reinfusion, and were assessed as regards hematologic and biochemical parameters. The autologous blood satisfied all the intraoperative transfusion requirements of the autologous group and 75 percent of the total transfusion requirements. The operative and postoperative blood losses—hence, the total blood loss-were less in the autologous than in the control group. The autologous blood had a high hemoglobin, white blood cell, and plasma hemoglobin content and MCV compared with the homologous blood. Postoperatively, there were no differences as regards the hematologic parameters studied. There was no evidence of intravascular hemolysis in the autologous group. Postoperatively, in both groups, AT Ill, plasminogen, and protein C decreased. Other coagulation parameters were within normal limits in both groups. Intraoperative autotransfusion is safe and effective, and should be considered in hip arthroplasty to reduce the risks associated with homologous blood transfusion.     

A comparison of autologous transfusion procedures in hip surgery

The risks associated with transfusion can be minimized with autologous blood. The efficiency of preoperative deposit, preoperative hemodilution and intra- and postoperative autotransfusion in reducing homologous transfusions has been demonstrated. There seem to be few studies, however, that compared the different methods of autologous transfusion. This study was designed to evaluate the comparative efficiency of these methods. PATIENTS AND METHODS. Sixty-four patients scheduled for total hip arthroplasty were randomly divided into four groups: group I--preoperative autologous deposit: group II--preoperative hemodilution; group III--intra- and postoperative autotransfusion; group IV--control. Preoperative autologous donations were stored in CPDA-1 buffer. Three units of 450 ml were requested. A predonation hemoglobin (Hb) concentration of 11 g dl was required. Surgery was carried out in the 5th week after the first donation. Preoperative hemodilution to Hb 9 g/dl was carried out after induction of anesthesia and initial circulatory stabilization. A cell separator was used for intra- and postoperative autotransfusion. Postoperative autotransfusion of drainage blood was continued until 6 h after the beginning of the operation. Polygeline was used for volume resuscitation. If the Hb concentration fell below 9 g/dl in the operating room and intensive care unit or below 10 g/dl in the general ward, autologous blood or homologous packed red cells were transfused. Autologous blood collected with the cell separator was retransfused at the end of the operation and after the autotransfusion period irrespective of the actual Hb concentration. RESULTS. The general data of the patients, blood loss, and Hb concentration at the beginning of the study and postoperatively were comparable in the four groups. Homologous transfusion requirements amounted to 0 (0-1250) ml (median, range) packed red cells in group I (preoperative deposit). 500 (0-2000) ml in group II (hemodilution), 125 (0-1000) ml in group III (autotransfusion) and to 500 (0-1500) ml in group IV (control). In group I 14 of 16 patients, in group II 1 of 16, in group III 8 of 16 patients, in group IV 5 of 15 patients did not require homologous transfusion. The difference between group I and IV was significant (p = 0.004 and p = 0.003). Global coagulation tests, antithrombin III, and total serum protein were comparable in the four groups. DISCUSSION. The efficiency of preoperative hemodilution to reduce homologous transfusion requirements is limited]. In the present study, as in two other recent studies, hemodilution did not reduce homologous transfusion requirements. Autotransfusion with a cell separator can save approximately 50% of the erythrocytes lost during hip arthroplasty and 70% of the drainage loss. The homologous transfusion requirements for the autotransfused group reported here were less than in the control group; the difference, however, was not statistically significant. Patients participating in preoperative autologous deposit did not require homologous blood for hip arthroplasty in 62%-70% of cases in other investigations; in the present study 88% of the patients did not require homologous blood. CONCLUSION. Under the conditions studied, preoperative autologous deposit was the most efficient method of autologous transfusion for hip arthroplasty. It should be employed primarily.     

Transfusion of previously deposited autologous blood for patients undergoing hip-replacement surgery

The efficacy of a program of transfusion of previously deposited autologous blood for patients undergoing total hip-replacement surgery was studied by comparing five different parameters for a group of fifty consecutive patients who deposited blood for autologous transfusion and a randomly chosen, closely matched control group of fifty patients who received only homologous blood. Sixty-two per cent of the patients in the group that deposited autologous blood did not receive additional homologous blood while in the hospital. The patients who deposited autologous blood had a mean preoperative hematocrit of 36 per cent, compared with 39 per cent for the control group, but the average postoperative hematocrits of the two groups did not differ (33 per cent). There was no significant difference in the average total loss of blood or need for replacement of blood between the groups. Transfusion-related complications developed in two patients in the control group. We concluded that previous deposit of autologous blood for transfusion is an effective method for reducing the need for transfusion of homologous blood and for avoiding the attendant complications of transfusion of homologous blood. This method of the replacement of blood should be considered for patients who are to undergo a major orthopaedic procedure on the hip.     

Feasibility of blood conservation strategies in pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension

Blood transfusion requirements were reviewed for a consecutive series of 25 patients undergoing elective pulmonary endarterectomy (PEA) between August 2005 and March 2009 in our institution. Patients were divided into two groups based on the implementation of a conservative blood transfusion algorithm that combined antifibrinolytic therapy, intraoperative blood sequestration, blood salvage and lack of correction of coagulation parameters in the absence of ongoing bleeding. Despite similar perioperative coagulation profiles in the two groups, the introduction of a conservative blood transfusion algorithm was associated with a significant increase in the number of patients receiving no homologous blood products. Of 16 patients who underwent surgery after the introduction of the algorithm, nine (56%) required no homologous blood products and five (31%) required one or two units of homologous red blood cells only. The international normalized ratio normalized within six to 12 hours after discontinuation of cardiopulmonary bypass without transfusion of fresh frozen plasma or platelets in 13 of the 16 patients. In conclusion, a conservative blood transfusion strategy allows PEA to be safely performed with no or minimal blood product transfusions in a majority of patients despite deep hypothermic circulatory arrest.     

Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial.

OBJECTIVE: Off-pump CABG is potentially associated with reduced intraoperative blood loss and homologous blood transfusion in comparison to on-pump CABG. In this randomised controlled study we investigated the effects of autologous cell saver blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing CABG on- versus off-CPB. METHODS: Eighty patients were randomised into one of four groups: (A) on-CPB with cell saver blood transfusion (CSBT), (B) on-CPB without CSBT, (C) off-pump with CSBT and (D) off-pump without CSBT. Volume of intraoperative autologous blood transfusion, postoperative mediastinal blood loss and homologous blood transfusion requirements were measured. Homologous blood was transfused when haemoglobin concentration fell below 8 g/dl postoperatively. Pre- and postoperatively prothrombin time and partial thromboplastin time were measured. RESULTS: Preoperative patient characteristics were well matched among the four groups. The amount of salvaged mediastinal blood available for autologous transfusion was significantly higher in the on-pump group (A) compared to the off-CPB group (C) (433+/-155 ml vs 271+/-144 ml, P=0.001). Volume of homologous blood transfusion was significantly higher in group B vs groups A, C and D (595+/-438 ml vs 179+/-214, 141+/-183 and 230+/-240 ml, respectively, P<0.005). The cell saver groups (A and C) received significantly less homologous blood than the groups without cell saver (160+/-197 ml vs 413+/-394 ml, respectively, P<0.005). Patients undergoing off-CPB surgery received significantly less homologous blood than those undergoing on-CPB CABG irrespective of cell saver blood transfusion (184+/-214 ml vs 382+/-397 ml, P<0.05). Postoperative blood loss was similar in the four groups (842+/-276, 1023+/-291, 869+/-286 and 903+/-315 ml in groups A to D, respectively, P>0.05). Clotting test results revealed no significant difference between the groups. There was no significant difference in postoperative morbidity between groups. CONCLUSION: Off-pump CABG is associated with significant reduction in intraoperative mediastinal blood loss and homologous transfusion requirements. Autologous transfusion of salvaged washed mediastinal blood reduced homologous transfusion significantly in the on-CPB group. Cell saver caused no significant adverse impact on coagulation parameters in on- or off-CPB CABG. Postoperative morbidity and blood loss were not affected by the use of CPB or autologous blood transfusion. We recommend the use of autologous blood transfusion in both on- and off-pump CABG surgery.     

A comparison of transfusion requirements after total knee arthroplasty using the Solcotrans autotransfusion system

Twenty-five consecutive total knee arthroplasties were performed with the Solcotrans unit for scavenging postoperative drainage (study group) and were compared with the previous 25 arthroplasties performed without the Solcotrans unit (control group). Mean preoperative hematocrits, estimated blood loss, and fluid replacement for both control and study groups were nearly identical. When the autotransfusion system was not used, 10 patients in the control group required transfusion of a total of 20 units of packed red blood cells, while only two patients utilizing the Solcotrans unit required transfusion of five units of packed red blood cells (P less than .01). The total amount autotransfused in the study group averaged 607.9 mm, and the hematocrit of the scavenged drainage was 29.3%. Samples from all autotransfusions were sent to the microbiology lab for routine culture and were finalized as no growth after 14 days. Serial postoperative hematocrits, platelet counts, prothrombin, partial thromboplastin, blood urea nitrogen, and creatinine values were compared between the two groups. No significant differences were found, and no evidence of coagulopathy, thrombocytopenia or renal dysfunction was found in the study group.     

两种自体输血方式在中央性前置胎盘孕妇中应用的安全性分析

目的探讨储存式自体输血和急性等容稀释式自体输血在中央性前置胎盘孕妇剖宫产术中应用的安全性及临床疗效。方法选择2013年1月至2016年9月在我院因中央性前置胎盘拟行剖宫产术的60例患者为研究对象。采用随机数字表的方法平均分为两组:A组为储存式自体输血组,B组为急性等容稀释式自体输血组。观察两组患者自体输血采血前后及手术后的血红蛋白(Hb)、血细胞比容(Hct)、血小板计数(PLT)、术中出血量、输血量、新生儿Apgar评分及Hb水平、输血不良反应等。结果两组患者出血量及输血量比较无显著性差异(P0.05)。两组患者采血前后及手术后的Hb、Hct、PLT比较亦无显著性差异(P0.05)。两组新生儿1分钟Apgar评分及Hb水平比较无显著性差异(P0.05)。两组患者中输注自体血的患者均未发生输血不良反应,术后恢复良好;输注异体血的患者中,B组仅有1例出现发热、皮疹,未出现严重不良反应。结论储存式自体输血和急性等容稀释性自体输血在应用安全性上无明显差异。在基层医院临床工作中,针对中央性前置胎盘患者,由于剖宫产输血率高,可以在综合评估患者具体情况后,对必要的患者选择自体输血。