人工关节置换术后自体引流血回输的观察研究

Reinfusion of autologous shed blood after joint replacement

目的探讨人工关节置换术后自体引流血回输的可行性。方法选择１９９６年２月～１９９８年３月３６例５６个关节置换患者，除术前预存自体血外，术后使用ＣＢＣⅡＣｏｎｓｔａＶａｃＴＭ型回输血器予自体引流血回输。其中髋关节８个，膝关节４８个；类风湿关节炎１２例，骨性关节炎１６例，强直性脊柱炎５例，其它特殊关节炎３例。结果自体引流血回输２４２６０ｍｌ，预存自体输血９７００ｍｌ，异体输血１４６００ｍｌ，分别占总输血量的５０％、２０％和３０％。１５例有一过性发热反应，无其它并发症。结论自体引流血回输是一种安全有效、简便易行、节约血源及财力的输血方式，可减少异体输血量，避免其并发症。

Objective To evaluate the results of reinfusion of autologous shed blood after joint replacement. Methods From February 1996 to March 1998,we selected 36 patients for 56 joint replacements. Apart from preoperative donation of autologous blood,all patients received refusion of unwashed autologous drained blood from hips and knees after arthroplasty.The CBCIIConstaVac TM blood conservation system was used to salvage shed blood. Among the patients, 8 hips and 48 knees were involved. 12 patients had rheumatoid arthritis,16 osteoarthritis,5 ankylosing spondylitis, and 3 other arthritis. Results 36 patients received 24260 ml (50%) autologous shed blood, 9700 ml(20%) predeposited autologous blood, and 14600 ml(30%) allogenic blood. 15 patients experienced transient febrile reaction at the time of reinfusion,no other clinic abnomalities were discovered after reinfusion. Conclusions Reinfusion of autologous shed blood is a safe and effective to decrease the use of allogenic blood and avoid the complications of its transfusion.