摘要
目的观察研究自身输血后与凝血、抗凝、纤溶相关的三个重要指标（1）凝血酶原片段（F1＋2）；（2）抗凝血酶Ⅲ（AT-Ⅲ）活性；（3）D-二聚体（D—D）的变化，为术中回收式自体血液回输技术的安全性提供依据。方法选择ASAⅠ-Ⅱ级、出血量超过500ml手术病人和急诊内出血超过500ml手术患者共44例，随机分为两组：观察组和对照组各22例，前者分别于麻醉前和回输完自体血液后30min抽取股静脉血液，后者分别于麻醉前和术毕或异体血液输完后30min抽取股静脉血液。采用SPSS12．01软件包进行统计学处理。结果两组F1＋2均有升高（P〈0．05）；两组病人抗凝血酶Ⅲ（AT-Ⅲ）血浆浓度均有显著降低；两组病人D-二聚体前后对比观察显示有增加趋势，但没有统计学意义（P〉0．05）。三种指标组间比较显示各组间均无显著差异（P≥0．05）。结论自体血液回输后三种指标变化主要与手术创伤有关，而术中回收式自体血液回输本身不会引起机体凝血和抗凝系统明显变化，实验组变化与对照组变化是一致的。从而进一步证实术中回收式自体血液回输技术安全、可靠。
Objective To observe changes ofprothrombin fragment 1 ＋ 2, antithrombin -Ⅲand D - dimer after autotransfusion for evaluating safety of autotransfusion. Methods Forty - four patients undergoing surgery with ASAⅠ-Ⅱ grades and hemorrhage above 500 ml were randomized into tow groups. Blood samples were taken from fenoris vein before anesthesia and after autotransfusion. Results Fragment 1 ＋ 2 levels in serum were increase significantly and antithrombin - Ⅲ decreased and D - dimer not changes. Conclusion There were some changes of blood coagulation and fibrinolysis system after autotransfusion, but they were moving changes for keeping balance of humen body. Results of two groups were same and showed that autotransfusion was safety and trusty.
