川芎嗪对回收红细胞和机体凝血功能影响的研究

目的观察川芎嗪对回收自体血中红细胞及回输血后机体凝血功能的影响，评价提高红细胞回收率的价值。方法40例择期脊柱手术患者，随机分成两组，试验组于收集血液前静脉滴注川芎嗪，并在肝素盐水和洗涤盐水内加入川芎嗪。检测回输血液样本的红细胞（RBC）、血红蛋白（Hb）、红细胞压积（HCT），计算红细胞回收率；测定术前、回输血后即刻、术后24h的血常规、凝血酶原时间（PT）、部分凝血活酶时间（APTT）、纤维蛋白原（FiB）；描记术前、回输血后即刻血栓弹性描记图（TEG）。对照组不予静脉滴注川芎嗪，肝素盐水和洗涤盐水内不加川芎嗪。结果试验组红细胞回收率高于对照组（75．3％±8．3％vs66．5％±5．3％，P〈0．01）；与术前比较，试验组回输血后Hb、HCT、PLT计数明显降低（P〈0．01），PT、APTT、反应时间（R）显著延长（P〈0．01），FiB和最大宽幅（MA）降低（P〈0．01），但两组变化趋势一致。结论川芎嗪能提高红细胞回收率，并且未对凝血功能产生明显的影响。

The effects of ligustrazine on red cells by intraoperative blood salvage and the changes in blood coagulation

Objective To investigate the effects on the red cell of the intraopertive blood salvage by li-gustrazine and the changes in blood coagulation after reinfusion ,on the basis of which to evaluate the value of re-trieval rate of red cell by ligustrazine. Methods Forty ASA Ⅰ～Ⅱ patients undergoing elective lumbar surgery were randomly divided into two groups. In study group, ligustrazine had been injected intravenously to the pa-tients 30 min before their blood was collected. And ligustrazine was put into the washing saline and heparinized saline. Shed blood of both groups were collected, filtrated, separated and washed before reinfusion to the pa-tients. Then the retrieval rate of red cell was calculated according to formula. Hemoglobin (Hb), hematocrit (HCT), platelet count(PLT), prothrombin time (PT), activated partial thromboplastin time (AFFr)and plasma fibrinogen concentration(FiB)of the samples were determined in such phases as before operation,after blood transfusion and 24 h after operation, respectively. Thromboelastography (TEG) was counted before operation and after reinfusion. As the negative control, no ligustrazine was put into the washing saline and heparinized and no ligustrazine was injected to the patients. Results In study group, the retrieval rate was markedly higher than the control group. In two groups, after reinfusion, Hb, HCT, PLT, FIB concentration and maxium amlitude (MA) de-creased significantly, but PT, APTT and reaction time (R) prolonged significantly. But the two groups show the same tendency of the parameter varieties. Conclusion Ligustrazine can increase the retrieval rate of red cell. And there was no significant difference on coagulation compared with the control group after reinfusion.