回收式自体输血在血液保护技术中的应用研究

目的:探讨自体血液回收技术在血液保护中的作用。方法:运用ZITI-2000型血液回收机进行术中自体血液回收与回输共116例,比较回输后HR、MAP、SPO2的变化;随机选择其中部分病例于术前、回输前、回输后、术毕24h采血测定HB、Hct、plt、纤维蛋白原(FIB)、凝血酶原时间(PT)和部份凝血活酶时间(APTT);比较回收原血和回输血的RBC、HB和Hct。结果:(1)平均每例回收血3379ml、回输血1235ml,异体输血率为25·8%。(2)术中自体血回输后HR减慢(P<0·01),MAP上升(P<0·01)。(3)HB和Hct在回输后升高(P<0·01);Plt在回输后择期病例低于术前(P<0·01),急诊病例无显著变化,但术毕24h两者均比术前升高显著(P<0·01)。(4)急诊病例FIB、PT和APTT于术后24h增加(P<0·01);择期病例在回输前和回输后FIB降低(P<0·01),而PT、APTT则延长(P<0·01),但均在正常范围。(5)回输血与回收原血比较RBC、HB和Hct均显著增高(P<0·01)。结论:自体血液回输后循环功能较稳定,对凝血功能无明显影响,可节约血源和避免输血并发症。但出血量较大时,还不能完全避免异体输血。

The Applicational Study of Intraoperative Autologous Callbacked Blood Transfusion in Blood Conservation

Objective:To inquire the values of intraoperative autologous callbacked blood transfusional technique in the blood conversation.Methods:116 cases with blood salvage and autologous blood transfusions were done by ZITI-2000 type intraoperative autotransfusional instrument,and the various of HR,MAP,SPO_2 were compared with.Some cases were selected randomly and recorded the varies of HB,Hct,Plt,fibrinogen(FIB),prothrombin time(PT),partial prothrombin time(APTT) at the time point of pre-operation,pre-transfusion,post-transfusion and 24 hours after operation respectively.The records of RBC,HR and Hct were compared between the primary salvage blood and callbacked blood accordingly.Results:(1)The mean volumes of callbacked blood were 3379 ml,recovery blood were 1235 ml.The rate of foreign body's blood infusion was 25.8%.(2)The HR were slowered and MAP increased significantly(P<0.01) during the surgery period after intraoperative autotransfusional.(3)HB and Hct were increased significantly(P<0.01) after intraoperative autotrans-fusional.But Plt of emergency patients were no change after retransfusion and 24 hours later were increased significantly(P<0.01);and Plt of pick-time surgery patients were decreased significantly(P<0.01)after retransfusion.24 hours later,its were increased significantly(P<0.01) than preoperation.(4)The FIB,PT,APTT were decreased or delayed significantly(P<0.01)at the points of postoperation of the emergency patients;the FIB were decreased significantly(P<0.01) at pre-reinfusion,and post-reinfusion PT and APTT were delayed with satistically significane(P<0.01),but the records were in normal.Conclusion:After intraoperative blood salvage and reinfusion,it can stain the circulation relatively without influnce to the coagulational functions significantly,can salvage the blood and avoid the complication of blood infusion.But it can't avoid foreign body infusion completely when sever hemorrhages.