自体血回输对高龄骨科患者围术期血液氧合的影响

目的：探讨自体血回输对高龄骨科手术患者围术期血液氧合的影响。方法选择骨科手术高龄患者40例，随机分为自体血回输组和对照组，每组20例，回输组术中应用自体血液回收机进行血液收集、回输，对照组输注同种异体血。观察2组患者分别于手术前（T1）、手术结束时（T2）、术后24 h（T3）抽取颈内静脉，桡动脉血，记录动脉血氧分压（PaO2）、混合静脉血氧分压（PvO2）、动脉血氧饱和度（SaO2）、混合静脉血氧饱和度（SvO2）、动脉血氧含量（CaO2）、静脉血氧含量（CvO2）以及氧摄取率（ERO2）；观察术中失血量、补液量、输血量，尿量及输血并发症情况。结果回输组输注异体浓缩红细胞量及血浆用量与对照组比较，差异有统计学意义（ P ＜0．05）。手术结束时，回输组 PaO2、PvO2、SvO2、CaO2、CvO2均高于对照组，差异有统计学意义（ P ＜0．05）；与对照组比较，回输组 ERO2降低（P ＜0．05）。结论自体血回输可显著减少老年骨科手术异体血输入，改善氧合，增加氧供，可安全用于高龄骨科手术患者。

Effects of autologous blood transfusion on blood oxygenation at peroperative period in elderly patients receiving orthopedics surgery

Objective To investigate the effects of autologous blood transfusion on blood oxygenation at peroperative period in elderly patients receiving orthopedics surgery.Methods Forty elderly patients who underwent orthopedic surgery in our hospital were randomly divided into autologous blood transfusion group ( n =20) and control group ( n =20).The patients in autologous blood transfusion group were treated by autologous blood recycling machine,however,the patients in control group were infused with allogeneic variant blood.The arterial oxygen pressure (PaO2 ), partial pressure of oxygen of mixed venous blood (PvO2 ), arterial oxygen saturation (SaO2 ), mixed venous oxygen saturation (SvO2 ), arterial oxygen content (CaO2 ), venous oxygen content (CvO2 ) and oxygen uptake rate (ERO2 ) were detected and compared between two groups before surgery (T1), at the end of the operation (T2),24h after operation(T3).Moreover the volume of intraoperative blood loss,fluid infusion,blood transfusion,urine,and blood transfusion complications were observed and compared between two groups.Results There were significant differences in the variant concentrated red cell infusion volume and blood plasma dosage between autologous blood transfusion group and control group ( P <0.05).At the end of operation,the levels of PaO2 , PvO2 , SvO2 ,CaO2 ,CvO2 in autologous blood transfusion group were significantly higher than those in control group ( P <0.05),however, the levels of ERO2 in autologous blood transfusion group were significantly decreased, as compared with those in control group ( P <0.05).Conclusion The autologous blood transfusion can obviously decrease allogenetic blood infusion volume in elderly patients receiving orthopedics surgery,moreover,which can improve oxygenation and increase oxygen supply, thus,which can be used safely in elderly patients receiving orthopedics surgery.