自体引流血回输在双侧人工全膝关节同期置换术中的应用

The study on the effects of reinfusion of autologous shed blood after simultaneous bilateral total knee arthroplasty

目的探讨双侧人工全膝关节同期置换术后自体引流血回输的作用。方法44例双侧人工全膝关节同期置换手术患者,31例术后使用CBCⅡConstaVacTM型回输血器予自体引流血回输作为观察组,13例术后仅异体输血作为对照组。记录回输血总量并观察两组术前、术后第2天、术后第7天红细胞、血红蛋白及红细胞压积的变化。结果观察组共回输自体引流血24980ml,占总输血量52.5%,人均输血量628ml,对照组共输异体血12000ml,人均输血量923ml,两组人均输血量有显著性差异(P<0.05)。两组术前与术后第2天血红蛋白及红细胞压积有显著性差异(P<0.05),术后第7天恢复接近正常。结论自体引流血回输是双侧人工全膝关节同期置换手术中安全有效、简便可靠的输血方式,可减少异体输血量,避免其并发症。

Objective To explore the effects of reinfusion of autologous shed blood after simultaneous bilateral total knee arthroplasty. Methods From Feb. of 2005 to Feb. of 2007, 44 patients undergoing knee arthroplasty were retrospectively analyzed. There were 31 patients who were treated by reinfusion of autologous shed blood of using CBC Ⅱ ConstaVacTM in the experimental group, and there were 13 patients who were treated by allogenic blood in the controlled group. We accounted the volumes of blood routine test and RBC, HGB, HCT in preoperation, 2 days after operation, 7 days after operation of them. Results The experimental group received 24980ml （52.5%） reinfusion of autologous shed blood, average volume was 628 ml. The control group received 12000ml autologous blood. There was a significant differences in two groups （ P 〈 0.05） in average blood volume. And there was a significant differences in two groups （ P 〈 0.05） in HGB, HCT in preoperative and 2 days after operation. The blood constituent reached normal 7 days after operation. Conclusion Reinfusion of autologous shed blood after simultaneous bilateral total knee arthroplasty is safe, economic and effective with less side reactions and high quality blood transfusion and avoids complication of transfusion.