自体血液回收对骨科手术患者胃黏膜内pH值的影响

目的 探讨自体血回输对骨科手术患者胃黏膜内pHi值(pHi)的影响.方法 将40例择期行骨科手术患者随机分为两组:回收组和对照组,每组20例.回收组术中应用血细胞回输仪进行血液收集、回输.采用鼻胃管空气二氧化碳张力计测定pHi.于切皮前,切皮后1h、2h及手术结束时四个时点(To、T1、T2、T3)记录 pHi,记录患者术中回收血量,异体浓缩红细胞量及血浆用量.结果 与T0时比较,两组各时点pHi均下降(P＜0.05);与对照组比较,观察组T0、T1时点pHi差异均无统计学意义(P＞0.05),但T2、T3时点观察组pHi分别为(7.381±0.023)、(7.386 0.025),均高于对照组的(7.361±0.022)、(7.375±0.024)(均P＜0.05).结论 骨科手术患者应用自体血液回输技术能及时回收失血,改善pHi 下降,维持有效循环,明显改善内脏微循环灌注和氧合.

Influence of autologous blood salvage on the gastric intramucosal pH in operation for orthopedic patients

Objective To explore the influence of autologous blood salvage on the gastric intramucosal pH （pHi） in operation for orthopedic patients. Methods 40 patients underwent orthopedic surgelT were randomly divid- ed into two groups （ n = 20 each）. Salvage group received autologous blood transfusion. The pHi was measured by a na- sogastric tube air carbon dioxide tension instrument. The blood samples were collected before operation（ To ）, lh after operation（T1 ） ,2h after operation（T2 ） and the end of surgery（T3 ）for the measurement of pHi. The volume of blood recovery, erythrocyte suspension and plasma were counted. Results The volume of erythrocyte suspension and plasma were significantly higher in control group than in salvage group during operation（ P 〈 0.05 ）. There was no obviously different in blood gas indexes in the two groups （ P 〉 0.05 ）. The pHi was significantly higher in salvage group （ 7. 381 ±0. 023 ）, （7. 386±0.025 ） ] than those in control group （7. 361 ± 0. 022 ）, （7. 375 ± 0. 024） ] at T2 and T3 （ all P 〈 0. 05 ）. Conclusion Autologous blood salvage could recover loss blood in time, and make pHi decline, and main- tain effective circulation, and significantly improved visceral microeirculatory perfusion and oxygenation in patients un- der went orthopedic surgery.