自体血回输对血胸机体免疫系统影响的研究

Intraoperative autologous blood autotransfusion on immune system in cardiothoracic trauma patients

目的 探讨在血胸患者的治疗过程中，采用自体血回输对患者机体免疫系统的影响。方法选择75例血胸患者，为胸部创伤致中等量血胸者，分为回输血、输库血及未输血3组，每组各25例患者，输血组于输血前、输血后1、3、7、15d各取患者静脉血10ml送检；未输血组于患者入院时、入院后1、3、7、15d各取患者静脉血10ml送检。检查反映免疫系统12项指标。结果回输血组患者术后IgA、IgM、CD4、sCD4、sCD8、sCD23、IL-2、IFNγ均有下降，15d后基本恢复正常，回输血组与未输血组比较，相对应各时间点上，各指标差异均无统计学意义（P〉0．05）。结论心胸创伤患者大量的胸内出血自体回输对机体免疫系统安全、可行，不存在明显的不良影响。

Objective To explore the effects of autotransfusion on the immune system in the treatment course of cardiothoracic patients. Methods By selecting 75 cases of hemothorax patients, whose moderate hemothorax was caused by chest trauma, and dividing them into three groups： transfuse back the blood, homologous blood transfusion and non -transfusion, each group with 25 patients. Transfusion group took 10 ml blood out of the vena for check 1,3,7,15 days before transfusion and after transfusion;non - transfusion group took 10 ml blood out of the vena for check 1,3,7,15 days on admission and after admission. The 12 indexes reflecting the immune system were tested. Results In transfuse back the blood group after operation,IgA,IgM,CD 4,sCD 4,sCD 8,sCD 23 ,IL -2,IFNγ all decreased,and returned to normal after 15 days;comparatively, there was no obvious difference in every data between transfuse back the blood and non - transfusion group（ P 〉 0.05）. Conclusions Intraoperative autologous blood autotransfusion is safe and workable to the immune system of cardiothoracic trauma patients,without any significant harmful effects.