回收式自体输血对脑膜瘤术后血肿的影响

目的:探讨回收式自体输血是否影响脑膜瘤术后血肿的发生,拓宽血液回收机在开颅手术中的应用.方法:90例择期脑膜瘤手术病人随机分为M组(实验组,n=60)和C组(对照组,n=30),M组病人采用美国Haemonetics Cell-Caver5血液回收机,行术中血液回输,分别于失血前、失血后、回输后监测血气、Hb和Hct.C组病人根据术中出血情况输注异体血.随访两组病人术后输注异体血的量、术后血肿发生情况及感染情况.结果:两组病人术中血流动力学稳定,术中Hb和Hct可维持在正常范围内.两组病人术后输注异体血量相似.术后血肿无显著差异.M组术后感染率低.结论:回收式自体输血不会影响脑膜瘤术后血肿的发生,可以安全使用.但应加强围术期的管理,以策安全.

Effect of intraoperative autotransfusion on postoperative hematoma of intracranial meningiomas

Objective:To evaluate the clinical effect of intraoperative autotransfusion on postoperative hematoma of intracranial meningiomas and to expand the clinical application of blood callbacked in intracranial surgery.Methods:90 patients undergoing elective surgery for intracranial meningiomas were randomly allocated to the M group (the experiment group, n =60) and the C group (the control group, n =30).In the M group,the autologous blood retransfusion was given with the Haemonetics Cell-Caver5,and the blood gas analysis,Hb,Hct were observed before hemorrhage,after hemorrhage and retransfusion respectively.In the C group,the allogeneic blood transfusion was performed considering the intraoperative hemorrhage.All patients were followed up for volume of allogeneic blood transfusion,postoperative hematoma and postoperative infection.Results:The hemodynamics was steady.The Hb and Hct were maintained in the normal range during operation in both groups.The blood volume of postoperative allogeneic transfusion showed no significant difference between two groups.The incidence of the postoperative hematoma showed no significant difference between two groups,but the incidence of postoperative infection was lower in the M group than that of C group.Conclusion:Intraoperative autotransfusion could not influence the incidence of postoperative hematoma of intracranial meningiomas.With the perioperative management,the intraoperative autotransfusion can be used safely for intracranial surgery.