改良超滤和机血快速回输技术在瓣膜替换术中的应用

THE APPLICATION OF MODIFIED ULTRAFILTRATION AND QUICKLY RESIDUAL BLOOD RETRANSFUSION IN THE PROSTHETIC VALVE REPLACEMENT

目的 在瓣膜替换术中应用改良超滤和机血快速回输技术 ,并评价其减少术后出血、降低术后并发症的效果。方法 148例风湿性心脏瓣膜病病人随机分为两组 ,88例采用改良超滤和机血快速回输技术 (实验组 ) ,与 6 0例常规手术 (对照组 )进行对比 ;比较两组病例术后出血和临床用血情况。结果 实验组停体外循环后红细胞压积明显增高 (P <0 .0 1) ,术后 2 4h出血量和术后库血用量明显减少 (P <0 .0 1) ,不输血病例数量增加。结论 改良超滤和机血快速回输技术能使术后创面渗血明显减少。

Objective To evaluate the efficacy of application of modified ultrafiltration and quickly residual blood retransfusion for the prosthetic valve replacement. Methods 148 patients undergoing valve replacement were randomized into two groups:the experimental group with modified ultrafiltration and quickly residual blood retransfusion (n=88);the control group with conventional cardiopulmonary bypass(CPB)(n=60). The change of hematocrit, volume of bleeding, total volume of banked blood transfusion was compared respectively between the two groups after CPB. Results The hematocrit and the number of patients without transfusion were increased significantly in experimental group compared with control group, while the bleeding volume and the total volume of banked blood transfusion within 24 hours after CPB were decreased significantly in experimental group. Conclusion The application of modified ultrafiltration and quickly residual blood retransfusion can significantly reduce the bleeding from the wound surface and the complications after cardiac valve replacement.