回收式自体输血及异体输血对凝血功能影响.docVIP

回收式自体输血及异体输血对凝血功能影响 　【摘要】 目的 比较自体输血和异体输血对患者凝血功能的影响。方法 32例择期脊柱手术患者，将同性别、同手术类型、年龄相近的两位病人配为一对，随机分配到回收式自体输血组(试验组)或异体输血组(对照组)中。试验组用Cell Saver R 5全功能自体血液回收机回收术中出血，经过滤、离心、洗涤后回输给病人。分别取手术前、输血前、输血后1h、手术后24h的静脉血，测定血常规(包括血红蛋白Hb、红细胞压积Hct和血小板Plt)、凝血酶原时间(PT)、部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)。结果 Hb、Hct、Plt、PT、APTT、FIB、TT在各测定点两组变化一致，组间变化均无显著差异(Pgt;0.05)。结论 回收式自体输血与异体输血对患者凝血功能的影响差异不显著。 【关键词】 输血 自体 血液凝固 Comparison of affection of autologous transfusion salvage and homologous blood transfusion on coagulation function 【Abstract】 Objective To compare the affection in blood coagulation function induced by autologous transfusion salvage and allogenic blood transfusion.Methods Thirty-two ASA Ⅰ～Ⅱ patients aged 14～65 yr undergoing elective major spinal surgery were paired according to their sex and type of surgery.The paired patients were randomly allocated to either autologous transfusion salvage group(study group) or homologous transfusion group(control group).In study group’shed blood was collected and heparinized.Red cells were separated and washed for reinfusion.In control group’red cells concentrate was infused.Hb Hct’platelet(Plt)’prothrombin time(PT)’activated partial thromboplastin time(APTT)’plasma fibrinogen concentration(FIB)’and thrombin time(TT) were determined.Results The two groups were comparable with regard to age’sex’duration of operation’blood loss［（1343±421）ml vs (1285±394)ml］ and the amount of crystalloid and colloid infused during operation.There were no significant difference in Hb’Hct’Plt’PT’APTT’FIB’TT between the two groups.Conclusion Autologous transfusion salvage induce no significant effects on blood coagulation as compared with homologous blood transfusion. 【Key words】 blood transfusion autologous blood coagulation 随着外科学的发展，失血量较大的手术(如肝移植、大型脊柱手术、复杂心胸外科手术等)开展得越来越多，从而导致输血病例的增加和每位输血病例平均输血数量的增加。输血已成为某些外科手术成功施行的基本条件和必要保证。回收式自体输血(Autologous Transfusion Salvage’ATS)既可减轻医疗用血负担，又能避免异体输血可能引发的感染、免疫及输血反应等并发症，已成功地应用于大量外科手术并明显地减少了异体血用量［1］。但由于回收血经洗涤后去除了血浆蛋白、血小板和凝血因子，输入大量回