自体血回输在肝脾破裂急诊手术中的应用及其作用探讨.doc

自体血回输在肝脾破裂急诊手术中的应用及其作用探讨 【摘要】目的 肝脾破裂急诊手术患者经常需要输入大量术中及术后异体血，其危险性包括溶血反应、病毒性肝炎感染、感染HIV或梅毒等。术中自体血回输是减少异体血输入的最常用的技术之一。方法 本研究旨在分析术中自体血回输能否具有减少肝脾破裂手术围术期异体血输入总量的作用，选取自2010年6月至2012年12月期间，行肝脾破裂的急诊手术63例，其中30例采用术中自体血回输(A组)，33例未使用术中自体血回输(B组)，回顾性比较两组病人的性别、年龄、体重、身高、疾病、手术时间、术前血红蛋白、术中出血量、自体血回输量、异体血使用量、术后引流量、围术期异体血使用总量。结果 A组和B组在性别、年龄、体重指数、疾病、手术时间、术前血红蛋白等方面差异无显著性；A组和B组之间在术中出血量及术后引流量上差异没有统计学意义，但在术中异体血、术后异体血输入量以及围术期异体血总用量的比较中，A组的异体血用量都显著少于B组。 结论 急诊肝脾破裂手术中，自体血回输不仅能够减少术中异体输血量，而且能减少围手术期异体血输入总量。 【关键词】自体血回输，术中输血，肝破裂，脾破裂 Efficacy of intraoperative blood transfusion in emergency operations of hepatic and splenic injuries [Abstract] Objective The emergency surgeries of patients with liver or spleen ruptures often need a lot of intraoperative and postoperative allogeneic blood, the risk of transfusion include hemolytic reaction, viral hepatitis infection, HIV infection or syphilis. Intraoperative autologous blood transfusion is one of the most commonly used technique to reduce the transfusion of allogeneic blood. Methods The purpose of this study is to analyze whether intraoperative autologous blood reinfusion can reduce amount of allogeneic blood transfusion in surgery and the total perioperative transfusion in liver or spleen rupture operations.We selected 63 patients who underwent emergency operations of liver or spleen rupture from June 2010 to December 2012, the allogeneic blood transfusion were used in 30 cases (group A) while the other 33 cases were not (group B), we retrospectively compare the two groups of patients the gender, age, weight, height, disease, surgery time, preoperative hemoglobin and red blood cell hematocrit, blood loss, the amount of autologous blood transfusion, allogeneic blood usage, postoperative drainage and total allogeneic blood usage. Results There were no significant differences between group A and group B in gender, age, body mass index, operation types, surgery time and preoperative hemoglobin; Besides, there is no statistically significant difference between