预存联合术中回收式自体输血对择期手术患者的临床研究

目的 探讨预存联合术中回收式自体输血对择期手术患者的临床效果。 方法 采用随机数字法将84例择期手术患者随机分为2组,每组42例。对照组给予异体输血,观察组给予预存联合术中回收式自体输血。治疗前后,检测患者血液相关指标(Hb、Hct、PLT、PT、APTT)、炎症介质(TNF-α、补体C3)、外周血T淋巴细胞亚群(CD4、CD4/CD8、CD8)和NK细胞、免疫球蛋白(IgA、IgG、IgM)水平,并统计不良反应发生情况。 结果 治疗后,观察组Hb、HCT、PLT、PT、APTT水平与治疗前比较差异无统计学意义(P>0.05);对照组Hb、HCT、PLT、PT、APTT水平则明显下降(P<0.05);且观察组Hb、HCT、PLT、PT、APTT水平显著高于对照组(P<0.05)。治疗后,观察组补体C3、CD4、CD4/CD8、NK细胞、IgA、IgG、IgM水平与治疗前比较显著升高(P<0.05);对照组补体C3、CD4、CD4/CD8、NK细胞、IgA、IgG、IgM水平则明显下降(P<0.05);而且观察组补体C3、CD4、CD4/CD8、NK细胞、IgA、IgG、IgM水平明显高于对照组(P<0.05)。治疗后,观察组TNF-α显著降低,而对照组TNF-α显著升高,且观察组TNF-α显著低于对照组 (P<0.05)。观察组不良反率为0.0%,显著低于对照组的14.3%(P<0.05)。 结论 相比于异体输血,预存联合术中回收式自体输血可有效调节患者炎症和免疫功能,利于预后恢复。 

Clinical study of preconditioned combined intraoperative recovering autologous blood transfusion in patients with elective surgery

Objective To investigate the clinical effect of preconditioned combined intraoperative recovering autologous blood transfusion in patients with elective surgery. Methods Eighty-four patients with elective surgery were randomly divided into two groups,each group 42 cases.Patients in control group were given allogeneic blood transfusion,and patients in observation group were given preoperative combined intraoperative recovery of autologous blood transfusion.Before and after treatment,the blood related indicators (Hb,Hct,PLT,PT,APTT),inflammatory mediators (TNF-α,complement C3),peripheral blood T lymphocyte subsets (CD4,CD4/CD8,CD8) and NK cells,immunoglobulin (IgA,IgG,IgM) of patients were detected,and the adverse reactions were accounted. Results After treatment,Hb,HCT,PLT,PT and APTT levels of observation group had no significantly differences compared to before treatment (P>0.05).Hb,HCT,PLT,PT and APTT levels of control group were significantly decreased compared to before treatment (P<0.05).After treatment,Hb,HCT,PLT,PT and APTT levels of observation group were significantly higher than those of control group (P<0.05).After treatment,complement C3,CD4,CD4/CD8,NK cells,IgA,IgG,IgM of observation group were significantly higher than those of before treatment (P<0.05).After treatment,complement C3,CD4,CD4/CD8,NK cells,IgA,IgG,IgM of control group were significantly lower than those of before treatment (P<0.05).After treatment,complement C3,CD4,CD4/CD8,NK cells,IgA,IgG,IgM of observation group were significantly higher than those of control group (P<0.05).After treatment,TNF-α of observation group was significantly lower than that of before treatment (P<0.05).After treatment,TNF-α of control group was significantly higher than that of before treatment (P<0.05).After treatment,TNF-α of observation group was significantly lower than that of control group (P<0.05).The adverse reaction rate of observation group was 0.0%,which was significantly lower than that of control group (14.3%,P<0.05). Conclusion Compared to allogeneic blood transfusion,preoperative combined intraoperative recovery of autologous blood transfusion could effectively regulate the inflammation and immune function,is helpful for prognosis recovery.