自体血液回收技术在大失血手术患者中的应用研究

目的：探讨自体血液回收技术对循环、血细胞和凝血功能的影响及应用效果。方法：选择急诊大失血手术患者27例,采用ZITI-2000型血液回收机回收血液,经过滤、离心、清洗后回输给患者。分不同时点观察HR、SBP、MAP、DBP、SPO2的变化,并监测RBC、Plt、HB、Hct、FIB、PT、APTT的变化。计算输血量和异体输血率。随机选择8例进行回收原血和回输血血细胞学比较。结果：（1）术前血压较低,心率较快,回输血液后,HR显著降低（P〈0.01）,SBP和MAP显著升高（P〈0.01）。（2）术前RBC、HB和Hct均低于正常水平,回输后各时点均升高明显（P〈0.01）。术前FIB和Plt低于正常水平,回输后各时点增高,但无显著意义。PT、APTT无明显变化。（3）回收原血平均每例3735 mL,回输血平均每例1589 mL,异体输血率为25%。（4）回输血RBC、HB和Hct均显著高于回收原血（P〈0.01）。结论：自体血液回收技术用于临床安全可靠,能有效维持循环的稳定,对凝血功能无明显影响,节约血源,减少异体输血。

Application of Autoblood-transfusion Technique During Operation on Massive Haemorrhage

Objective：To study autoblood collector＇s application effect and the influence on circulation,blood cell and blood clotting function.Methods：The ZITI 2000 blood collector was used to collect the lost blood during emergency operations.27 cases were evaluated.to observe the differention of HR、SBP、MAP、DBP、SPO2 and RBC、Plt、HB、Hct、FIB、PT、APTT in different time;to calculate the volume of blood-transfusion and the rate of variant blood-transfusion;to compare the hemocytology of collected lost blood with transfused blood,8 cases were selected in random.Results：（1） After blood-transfusion,HR depressed,SBP and MAP advanced obviously（P〈0.01）（2） Post-transfusion,the RBC,Hb and Hct advanced obviously（P〈0.01）;Preoperative,the RBC,Hb,Hct,FIB and Plt were lower than the normal level.（3） The average volume of collected lost blood,transfused blood was 3735mL,1589 mL,the rate of variant blood transfusion was 25%.（4） The RBC,Hb and Hct of transfused blood was obviously higher than the collected blood（P〈0.01）.Conclusion：Collecting the lost blood during operation with ZITI 2000 blood collector is safe and effective.It can keep the circulation stabilization,have non-obviouse influrence on blood clotting function,save the blood supply and reduce the variant blood transfusion.