术中血液回输技术对脊柱外科围手术期病人出凝血和血携氧功能影响.docVIP

术中血液回输技术对脊柱外科围手术期病人出凝血和血携氧功能影响 　　摘要：目的：探讨术中血液回输技术对脊柱外科围术期病人出凝血和血携氧功能的影响。方法：筛选2010年1月至2013年1月期间在我院骨科住院就诊的100例本市脊柱损伤患者，根据手术的方法平均分为5组，分别是脊柱骨折前路手术组、脊柱骨折后路手术组、腰椎滑脱内固定手术组、脊柱侧弯矫治术组、多节段椎间盘突出症并椎管狭窄组、检测各组患者术前、术后24小时、术后7天血液中血红蛋白（Hb）、氧分压（PaO2）、血小板（PLT）等指标，同时比较5组患者回收式自体输血（ATS）量的变化及其对出凝血状况和血携氧功能的影响。结果：100例共输血75350ml，自体血回输59390ml，所占比例78.82%，在手术后各时间段内红细胞比容（HCT）、PLT水平均出现下降，空腹血糖（Fbg）无明显差别，而PaO2水平上升明显。结论：围手术期虽有轻度贫血但不影响血携氧功能，术后PT显著延长却未出现出凝血功能障碍，ATS技术能明显减少异体血用量，可安全应用于脊柱外科手术。 关键词：血液回输技术 脊柱外科围术期 出凝血 血携氧 Doi：10.3969/j.issn.1671-8801.2013.07.043 Intraoperative autotransfusion of blood coagulation and blood oxygen carrying function of spinal operation in the perioperative period of patients Zeng Jin Luo Shurong Abstract：Objective：To investigate intraoperative autotransfusion of blood coagulation and blood oxygen carrying function of spine surgery patients in perioperative period. Methods：From January 2013 screening during the 2010 January hospitalized in Department of orthopedics in our hospital 100 cases the spine injury patients， according to the methods of operation were divided into 5 groups， respectively is the fracture of spine anterior operation group， operation group， spinal fractures of posterior lumbar spondylolisthesis internal fixation operation group， the spinal scoliosis correction surgery group， multiple intervertebral disc herniation and spinal canal stenosis group， patients in each group were determined before surgery， 24 hours， 7 days after operation， blood hemoglobin （Hb）， partial pressure of oxygen （PaO2）， platelet （PLT） and other indicators， at the same time， compared 5 groups of patients with autologous blood transfusion （ATS） affect the amount of change and the coagulation status and blood oxygen carrying function.Result：100 cases of transfusion of autologous blood transfusion in 75350ml， 59390ml， the proportion of 78.82% in different time after the operation， red cell volume （HCT）， PLT levels were decreased， fasting blood glucose （Fbg） had no significan