体外循环心内直视手术少用或不用血的临床研究

The Diminishing Allogeneic Transfusion or without Transfusion in the Perioperative Periods of Open Heart Surgical Procedures

目的 :研究体外循环心内直视手术少用或不用血的可行性 .方法 :选择 12 0例常规心脏手术患者 ,随机均分为对照组 (A)和实验组 (B) .A组采用预充库血 ,体外循环结束后不回输剩余机血 ,B组采用无血预充 ,术前放血 ,体外循环结束后 ,回输全部机血 .结果 :B组围术期异体库血用量较A组减少 5 0 % ,严格输血指征 ,病人全部康复出院 .结论 :采用无血预充 ,中度血液稀释 ,回输机血 ,加强血液保护 ,减少库血用量或不用库血 ,对病人无不良影响 。

Objective: To reduce the perioperative need of allogeneic transfusion or without transfusion for prevention of blood transmitted diseases after cardiovascular surgery. Methods: 120 surgically treated patients with cardiovascular diseases were studied prospectively. All patients were divided into two groups. In group A (n=60, control) blood transfusion was applied but without transfusion of residual oxygenator blood. Transfusion criteria [hematocrit (Hct)<35%]. In group B (n=60, test) moderate hemodilution was applied with Transfusion of residual oxygenated blood. The data from two groups were analyzed and compared on the time of extracorporeal circulation, the average time of postoperative ventilation, amount of drain. Hct was measured during the perioperative period on the postoperation 1st day. Results: 16 out of test group did not need allogeneic transfusion during perioperative periods. While all patients in the control group applied allogeneic transfusion. The average allogeneic transfusion in all patients in test group was (320.00±239.92)mL during the operation. In contrast, the average allogeneic transfusion in the control group was (622.50±320.01)mL during the perioperative periods. There were significant difference between the two groups during perioperative period (P<0.01). However, there was no significant difference in the age, body weight, postoperative ventilated time, ICU stay, amount of drain between the control and test group(P>0.05). But the Hct of postoperation 1st day and the 7?th day was significant. Conclusion: The operative curative effect is not influenced thereby. Less allogeneic transfusion or no transfusion is feasible in perioperative cardiovascular surgery, so blood transmitted diseases can be prevented.