自体血液回输提高脊柱手术用血安全性的研究

Study of autohemotransfusion on improving ,the safety of transfusion in spinal operation

目的探讨术中自体血液回收回输在脊柱外科手术中的安全性和效果。方法选择腰椎内固定手术患者112例，将患者按病案号尾数奇偶性分为两组，奇数为观察组57例，偶数为对照组55例。观察组用血液回收机在术中进行血液回收回输，患者术中血细胞比容（Hct）〈30％时输自体血；对照组当血细胞比容（Hct）〈30％时输库存血。观察两组患者术前、术后血色素Hb和血球压积Hct对照比较，观察两组患者术中自体血回输量、输库血量、失血量、及代血浆用量的对照比较。结果两组患者术前、术后血色素Hb和血球压积Hct以及失血量比较差异无统计学意义（t分别为1．61，1．26，0．25，0．31；P〉0．05），而术中自体血回输量、输库血量及代血浆用量比较，差异有统计学意义（t分别为5．68，7．18，1．92，3．29；P〈0．05）。结论自体血液回收回输技术可减少或不用库存血，既解决了节约用血，又减少了输血后并发症，提高了输血的安全性，是脊柱手术中安全用血的最佳选择。

Objective To explore the safety and effect of autohemotransfusion in spinal operation. Methods 112 patients received lumbar vertebral reduction fixation were reviewed, all patients were divided into 2 groups according to the parity number of medical records, 57 cases in experimental group with the odd numbers, 55 eases in control group with the even numbers. Autohemotransfusion was applied by using cell saver in operation when the hematocrit of patient lower than 30 percent in experimental group, but store blood was given to the patients in control group. Hemoglobin and hematocrit in perioperative period in the two groups were investigated, the volume of autohemotransfusion, store blood, blood losses and plasma substitute were compared between the two groups. Results Hemoglobin, hematocrit and blood losses in perioperative period were similar in the two groups（ t = 1.61, 1.26, 0. 25, 0. 31 ,P 〉 0.05 ）. the volume of autobemotrausfusion, store blood and plasma substitute were different, and there was statistically significant difference between the two groups （t = 5.68, 7.18, 1.92, 3.29, P 〈 0. 05 ）. Candusions The au, tohemotransfusion technique can reduce the dosage of store blood , and it is the optimal choice in spinal operation for the advantages of saving store blood, reducing complications and improving the safety of transfusion.