体外循环手术中自体输血的临床研究

Perioperative Autohemotransfusion in the Cardiac Operation with Extracorporeal Circulation

目的通过将自体输血等多种节血措施综合应用于体外循环(extracorporeal circulation,ECC)心脏手术,观察不用或少用异体库血进行心脏手术的效果。方法对30例进行ECC心脏手术患者(实验组)术中采用综合节血措施,包括术前及ECC前采集自体血贮存术后回输、回输剩余机血、术前和术中应用药物保护血液提高凝血功能等。同期选择30例异体输血的心脏手术患者作为对照组,比较两组间血小板(Plt)、血红蛋白(Hb)、红细胞比积(Hct)、异体输血量及术后纵隔引流量等差异。结果实验组与对照组相比,术后Plt、Hb和Hct均无统计学显著性差异(P>0.05),而术后引流量、异体输血量实验组明显少于对照组(P<0.05)。结论心脏直视手术采用自体输血等多种综合节血措施,能明显减少手术出血,少输或不输异体血。

OBJECTIVE To study the effect of perioperative autologous blood transfusion in the cardiac operation with extracorporeal circulation（ECC）.METHODS In 30 cases（study group） undergoing the cardiac operation of ECC,comprehensive measures of blood conservation were taken,including autologous blood collected before operation and ECC,retransfusion of blood and protecting blood with drugs during operation.Other 30 cases undergoing the operation with homologous blood transfusion were chosen as control group.Several variances,such as postoperative hemoglobin（Hb）,platelet（PLT）,hematocrit（Hct）,the volume of homologous blood transfusion and the volume of postoperative drainage were compared between the two groups.RESULTS There were no significant differences between the two groups in postoperative Hb,PLT and Hct,but the volume of homologous blood transfusion and postoperative drainage were significantly different.CONCLUSION Comprehensive measures of blood conservation in the cardiac operation,such as autohemotransfusion,can significantly reduce the volume of blood loss during operation and homologous transfusion.