颅脑手术中清洗后回收血液质量的研究

A study on the quality of the processed blood salvaged during brain surgery

目的检验颅脑手术中血液回收机处理后回收血液的质量。方法20名颅脑疾患择期手术患者,应用自体-2000型血液回收机回收术野出血,经抗凝、过滤、离心及清洗后回输。测定血液回收机对收集血的处理过程中血小板、白细胞、K+和游离血红蛋白的清除率。用扫描电子显微镜对5份清洗后的血样及5U库存2周的红细胞悬液进行超微形态学检验,观察红细胞的形态。结果储血罐内收集血的溶血率达到(8.57±0.35)%,血液回收机的离心清洗过程中血小板、白细胞、K+和游离血红蛋白的清除率分别为:(85.4±7.3)%、(38.8±17.1)%、(90.4±4.4)%及(92.7±2.9)%。扫描电子显微镜下虽然可见回收血液中含有部分变形的红细胞,但红细胞的形态正常率仍达到(58.0±8.0)%。而库存2周的红细胞悬液中含有更多变形的红细胞(P<0.01)。结论在颅脑手术中收集的血液,溶血程度较重,但经血液回收机处理后,其质量较好。

Objective To assess the quality of the salvaged blood processed by the autotransfusion device-Ziti-2000 during brain surgery. Methods Twenty patients scheduled for elective brain surgery were enrolled in this study, and one Ziti-2000 autotransfusion device was used to process the collected blood salvaged during the operation. The intraoperatively shed blood was collected, washed, and retransfnsed to the patients. The efficacy of eentrifugation and washing was assessed by determining the elimination rate （ER） of Pit, WBC, K^＋ , and fHb. The morphology of the washed erythrocytes and the 2-week-old banked BBCs was observed by means of scanning electron microscopy. Results Extensive hemolysis was observed in the collected blood, with the percentage of hemolysis being （ 8.57 ± 0. 35） %. The ERs of Pit, WBC, K＊, and fHb were 〉 80%, 〉 35%, 〉 90%, and 〉 90%, respectively. Although some shape changed red blood cells were observed in the washed blood, discocytes were the dominant form, with the percentage of discocytes being （58.0 ± 8.0）%. A greater number of shape-changed red blood cells were found in 2-week-old banked RBCs （P 〈 0. 01 ）. Conclusion For brain surgeries, the quality of salvaged blood processed by Ziti-2000 is satisfactory. Although extensive hemolysis was noted in the collected blood, intraopcrative blood salvage can be effective and safe.