全膝关节置换术后自体引流血经过滤抗凝后回输的安全有效性分析

①目的探讨全膝关节置换术后自体引流血经过滤抗凝后回输的安全性和有效性。②方法使用回顾性评估设计，将42例全膝关节置换患者分为A、B两组。 A组15例，未进行自体血回输；B组27例，进行了自体血回输。分析自体血经过滤后回输的影响、出血倾向、出血量、异体输血比例和术后血红蛋白水平的变化等因素。③结果术后48小时内异体输血比例A组为26．7％（4/15），B组为0；术后14天异体输血比例A组为46．7％（7/15），B组为7．4％（2/27）；平均出血量A组为（600＆#177;150）mL，B组为（590＆#177;160）mL；术后第1、7和14天血红蛋白水平平均下降值：A组分别为（2．9＆#177;1．5）、（2．9＆#177;1．6）和（2．3＆#177;1．5）g/dL ，B组分别为（2．7＆#177;0．8）、（4．0＆#177;1．0）和（2．9＆#177;1．3） g/dL。④结论自体血回输降低了异体输血的比例，而血液抗凝并没有增加出血量。全膝关节置换术后抗凝血的自体回输在节约用血方面是安全有效的。

Security and effectiveness of autologous drainage bIood re-transfusion after filtered anticoagulation following total knee arthroplasty

Objective To discuss The security and effectiveness of Autologous drainage bIood re -transfusion after filtered anticoagulation following total knee arthroplasty .Methods using the retrospective assessment of design ,42 cases of total knee ar-throplasties which were carried out in our hospital ,the cases were divided into A、B two groups .27 cases in group A used autotransfu-sion drains,while the other 15cases in group B did not .We analyze the factors of the effect of Autologous drainage bIood re -transfu-sion after filtered anticoagulation ,hemorrhagic tendency ,amount of bleeding ,the proportion of allogenic blood transfusion and the Hb level after surgery.Results the proportion of allogenic blood transfusion in group A is 26.7%（4/15）postoperative drainage volume within 48h ,while the group B is 0;the proportion of allogenic blood transfusion in group A is 46.7%（7/15）postoperative drainage volume within 48h ,while the group B is 7.4%（2/27）,the average transfusion volume in group A is （600 ＆#177;150）mL,the group B is （590 ＆#177;160）mL,the first day ,the seventh day and the fourteenth day after operation ,the Hb level fell by an average,（2.9 ＆#177;1.5）, （2.9 ＆#177;1.6） and （2.3 ＆#177;1.5） g/dL in group A,（2.7 ＆#177;0.8）,（4.0 ＆#177;1.0） and （ 2.9 ＆#177;1.3） g/dL in group B ,respectively.Conclu-sion Autologous blood transfusion decreased the ratio of allogeneic blood transfusion , but blood anticoagulant did not increase the amount of bleeding .The autologous blood transfusion is safe and effective after total knee arthroplasty .