应用不同洗涤液对自体输血红细胞pH值和电解质的影响

Influence of Washing Autotransfusion with Different Washing Liquid on PH and Electrolytes

[目的]比较使用三种不同洗涤液对自体输血红细胞pH值和电解质的影响差异.[方法]术中洗涤式自体输血患者90例,随机分为三组,A组采用生理盐水,B组采用复方氯化钠溶液,C组采用乳酸钠林格液分别对回收血洗涤并回输,比较三组手术前、回输前、回输后及洗涤后红细胞的pH值和电解质变化情况.[结果]A、B两组患者回输后红细胞pH值较手术前降低,血Cl^-较手术前升高,C组各项指标无明显改变.洗涤后红细胞与人体正常值比较：A、B两组pH值较正常值低,C组与正常值无差异;三组Na^＋均较人体正常值高,组间A组Na^＋增高更加明显;A、B组Cl^-均较人体正常值高,C组与正常值比较无统计学差异.A组K^＋、Ca^2＋均较人体正常值低,B、C组与正常值无差异.[结论]自体输血时采用生理盐水和复方氯化钠溶液洗涤,可使患者红细胞pH值降低,血Cl^-升高,在大量输入自体血时有产生高氯性酸中毒的危险,使用乳酸钠林格液可改善这一状况.

[Objective] To compare the influences of washing autotransfusion with three different washing liquid on PH and electrolytes. [Methods] A total of 90 patients experienced intraoperative washing autotransfusion were enrolled in this study. All patients were divided into three groups randomly. Normal saline was used during autotransfusion in group A, and compound sodium chloride was used for group B, and Ringer＇s lactate solution was used for group C. The changes of PH and electrolytes before operation, before and after autotransfusion and after washing were compared among three groups. [Results] Compared with before operation, PH decreased and blood Cl^ increased after autotransfusion in group A and group B, but there was no change in group C. Compared with normal reference value of erythrocytes after washing, PH decreased in group A and B, while there was no difference between group C and normal value. The levels of Na^＋ in all three groups were higher than normal value, while a significant increase was observed in group A. The levels of Cl^ in group A and B were higher than normal value, but not in group C. The levels of K^＋ and Ca^2＋ in group A were lower than normal value, but not in group B and C. [Conclusion]Utility of normal saline and compound sodium chloride during autotransfusion can decrease the PH and increase the level of Cl^- , which may increase the risk of hyperchloremie acidosis. Ringer＇s lactate solution can avoid such potential risk.