冠状动脉旁路移植术后自体血液回输减少血液制品的应用经验

目的总结非体外循环下冠状动脉旁路移植术（OPCABG）后应用自体血液回输以减少血液制品的经验。方法将2007年8月至2011年8月北华大学第二附属医院心脏外科44例OPCABG患者随机分为自体血回输组（试验组）和异体血输血组（对照组），每组各22例。试验组应用非洗涤过滤式自体引流血回输；对照组未用自体引流血回输。结果试验组自体引流血液回输量（774．9±278．7）ml，输异体红细胞悬液（744．4±．375．5）ml；对照组输异体红细胞悬液（1200．0±357．9）ml。试验组回输自体血量占输血总量的27．8％～96．0％，平均减少了47．9％以上的异体血输入量。术后随访1个月，两组无一例新桥梗阻及血栓形成，无一例再发心绞痛症状。试验组与对照组输异体血量差异有统计学意义（P〈0．01），而输异体血浆差异无统计学意义（P〉0．05）。结论OPCABG术后应用一次性回输器回收自体引流血可以显著减少异体血输入量。

The utilization of autologous blood transfusion after off-pump coronary artery bypass graft reduced the waste on blood products

Objective To investigate the clinical value of autologous transfusion of unwashed filtered shed blood collected after off-pump coronary artery bypass （OPCABG）. Methods From August 2007 to August 2011, Our Hospital OPCABG patients were randomly divided into pairs of autologous blood transfusion group （experimen-tal group） and homologous blood transfusion group （control group）, 22 patients in each group. The first group ap-plied of non-washing filter autologous drainage blood reinfusion. The second group did not use it. Results Experi-mental group reinfusion of autologous blood transfusion accounts for the ratio of total 27.8% to 96.0%. The average amount of homologous blood decreased 47.9%. Patients were followed up 1 month. The bridge vessel has no ob-struction and thrombosis in two groups. No case of recurrent symptoms of angina. In experimental group and control group, the blood transfusion has a significant difference （P〈0.01）, while the transfusion of plasma had no signifi-cant difference. Conclusion OPCABG a one-time postoperative reinfusion of autologous drainge blood recovery device can significantly reduce the amount of homologous blood.