预自血回输在使用止血带的长时间下肢骨科手术中的意义

目的：探讨预自血回输在使用止血带的长时间下肢骨科手术中的意义。方法选择下肢骨科创伤拟行手术治疗的患者60例，随机数字表法分成常规组（30例）和预自血回输组（30例），均采用腰硬联合阻滞麻醉与止血带，预自血回输组患者在术中给予京精3000P型血液回收机作自血回收处理，常规组则尽量减少放止血带时的出血，必要时才给予异体输血。比较两组患者的手术时间、术中出血量、输血率及输血量（包括术后异体输血）、有无输血反应以及术前30min、术后180min、术后第1天的血红蛋白（Hb）含量。结果预自血回输组的术中自血回输量多于常规组的异体输血量，差异有统计学意义（P＜0.05），常规组术后异体输血率高于预自血回输组，差异有统计学意义（P＜0.01）；预自血回输组术后第1天Hb含量高于常规组，差异有统计学意义（P＜0.05）。结论预自血回输在使用止血带的长时间下肢骨科手术中有较好的血液保护作用，能有效提高患者Hb含量，明显减少患者术中与术后异体输血的概率。

Application of pre-autologous blood transfusion in prolonged orthopedic surgery of lower limbs using tourniquet

Objective To assess the application of pre- autologous blood transfusion in prolonged orthopedic surgery of the lower limbs using tourniquet. Methods Sixty patients with lower limb trauma underwent surgery under epidural anesthesia and tourniquet was used during the operation. Patients were randomly divided into two groups：in study group（n=30） pre- autolo-gous blood transfusion was applied with a Jing Jing 3000P blood recovery machine during the operation and in control group （n=30） al ogeneic blood was transfused only in case of need. The operation time, intraoperative bleeding volume, transfusion rate, transfusion volume, transfusion reaction, hemoglobin content at preoperative, intraoperative period and d1 after surgery were compared between two groups. Results The blood volume of autotransfusion in study group was higher than that of al ogeneic blood transfusion in control group （P〈0.05）. The rate of blood transfusion after operation was higher in control group than that of study group （P〈0.01）. Hb levels at d1 after surgery was higher in study group than that in control group （P〈0.05）. Conclusion Pre- autologous blood transfusion has protective effect in prolonged lower limb orthopedic surgery with tourniquet used, and can effectively improve the hemoglobin content and significantly reduce the blood transfusion after operation.