自体血液回输在心脏瓣膜替换手术中的应用

目的 探讨术中血液回输技术的安全性和效果,评价其在心脏瓣膜替换手术中的应用价值.方法 本研究共选人单个心脏瓣膜替换手术32例,随机分为2组.所有患者均于全身麻醉和体外循环下行心脏瓣膜替换手术.对两组患者术中出血量.术中自体血液回输量,异体血输入量,手术前、输血前、输血后血常规和动脉血气分析结果进行观测,记录输血并发症的情况.结果 两组术中出血量差异无统计学意义;两组患者术前、输血前、术后血红蛋白（HGB）、红细胞比积（HCT）比较,差异均无统计学意义;两组血气分析的pH值、血钾、乳酸比较差异无统计学意义（P〉0.05）;而两组库血输入量差异有统计学意义（P〈0.01）.两组均未观察到有输血并发症发生.结论 在体外循环下心脏瓣膜置换术中自体血液回输可有效地减少围术期自体血的丢失,补充血容量,维持有效循环,同时明显减少异体血的用量及并发症发生,是安全、有效的,有很高的临床应用价值.

The application of autologous blood transfusion in heart valve replacement surgery

Objective To assess the safety and efficiency of autologous blood transfusion in intra-operative blood salvage （IBS） during heart valve replacement. Methods Thirty-two patients undergoing general anesthesia and extracorporeal circulation for single valve replacement were allocated to two groups by stratified randomization. The total blood loss, blood salvage, volume of autologous and allogeneic blood transfusion blood routine test, arterial blood gas analysis before operative, pre-blood transfusion and after blood transfusion and the complications of the blood transfusion were recorded. Results There were no significant difference in total blood loss, the HGB and HCT compared with preoperative, pre-blood transfusion, after blood transfusion. No complications of the＂ blood transfusion in two groups. Conclusion Undergoing general anesthesia and extracorporeal circulation for single valve replacement, the blood salvage （IBS） could effectively reduce the total blood loss and the use of allogeneic blood volume.