自体血在腹主动脉瘤手术中应用的临床观察

Clinical observetion of autologous transfusions in abdominal aortic aneurysm repair

目的比较自体血与库血的质量及对腹主动脉瘤手术患者的影响。方法择期行肾下型腹主动脉瘤手术患者40例,随机均分为库血组(Y组)和自体血组(Z组)。记录术中出血量、补血、补液情况;对清洗浓缩后的自体血与库存异体血行血气分析,并检测患者手术前后的血常规、肝肾功能和血生化;记录输血相关并发症。结果 Z组异体RBC用量明显低于Y组(P<0.01);Y组PO2、Na+低于,K+、血糖、乳酸和Hb含量高于Z组(P<0.01);两组患者术后第1天、第3天WBC均高于术前,Plt均低于术前(P<0.01),但两组差异无统计学意义;Y组术后第1天肝功能、肾功能有轻度的损伤,显著高于术前及Z组(P<0.05);Y组输血后并发症高于Z组(P<0.05)。结论自体回收的血液质量优于异体库存血,自体血液回输后可降低异体血用量,减少术后脏器功能紊乱,可安全、有效地应用于腹主动脉瘤手术。

Objective To evaluate the outcome of autologous and allogeneie transfusions in abdominal aortic aneurysm surgery. Methods Forty elective abdominal aortic aneurysm surgery patients were randomly divided into two groups： autologous blood transfusion group （salvage and reinfusion,group Z） and allogeneie blood transfusion group（group Y）. The results of the blood gas analysis, blood routines, serum biochemistry parameters and complications were achieved before the operation, on the 1st day and the 3rd day after operation. Results The transfusion volume was less in group Z than that in group Y（P〈0.01）. The PO2 ,Na＋ was lower, hut K＋ , glucose, lactic acid content and Hb in group Y were higher in group Z（P〈0. 01）. The WBC was higher and the Plt were lower than baseline （P〈0.01）, without difference between two groups. There were mild liver and renal dysfunction in the allogeneic group（P〈0. 05）. The complications were less in autologous group （P〈0.05）. Conclusion Autologous transfusion can be safely used in abdominal aorta aneurysm repair surgery with reduced allogeneic blood needs and reduced postoperative organ dysfunction