自体血液回收术在肝移植中的应用

目的 观察肝移植术中应用自体血液回收技术的安全性和效果。方法 对9例原位肝移植患者术中应用Cell Saver5型血液回收机进行自体输血。记录术前、术后1d红细胞计数（RBC）、血红蛋白（Hb）、血球压积（HCT）、血小板（PLT）、凝血酶原时间（PT）和部分活化凝血活酶时间（APTT），术中根据血常规及凝血功能检查结果及时补充各种血液成分和鱼精蛋白。同时记录术中出血量、回收血量及回输浓缩红细胞量。结果 术中平均每例出血9145ml，平均每例回收血量6688ml，平均每例回输浓缩红细胞量3651ml。术中所有患者血流动力学稳定，仅术后24h血小板计数略低于术前，但差异无显著性（P〉0．05）。结论 肝移植术中采用自体血液回输技术，可为患者及时提供浓缩红细胞，避免大量异体血输入，确保输血安全。

Application of Autologous Blood Salvage Technique in Orthotopic Liver Transplantation

Objective To observe the safety and effect of autologous blood salvage technique used during orthotopic liver transplantation(OLT). Methods The cell saver 5 blood recollection system was applied to collect the blood loss during operations to nine patients with OLT, after anticoagulation,filtrating,centrifugalization and wash treatment,the concentrated red cells were transfused back to the patients. The red blood count(RBC), hemoglobin(Hb),hematocrit(HCT), plateletcount(PLT),prothrombin time(PT) and activate partial thromboplastin time(APTT) were recorded one day before the operation and one day after operation.During the operation,the patients were transfused various blood ingredients and protamine in time according to the result of routine,coagulation function blood tests,at the same time to record the blood loss, recollection volume and transfused concentrated red cell amount during operation.Results The average of blood loss per patient was 9 145 ml,6 688 ml blood per patient was recollected during operation,3 651 ml of concentrated red cell from autologous blood per patient was transfused back.All patients hemodynamics were stable during operation.Only after 24 hours of the operation the platelet count is less than the one before the operation, but no statistic meaning (P>0.05). Conclusion By using autologous blood salvage technique during liver transplantation operation, patients can get the concentrated red cells in time, therefore large amount homologous transfusion can be avoided. It has tremendous economic and social impacts as well as the safety is guaranteed.