全关节置换术后自体引流血的回输应用

Postoperative drainage blood reinfusion in total joint arthroplasty

目的 :评价全关节置换术后自体引流血回输的临床意义和使用的安全性。方法 :对 2组条件相似的初期关节置换的5 0例患者进行了前瞻性研究。实验组 ( 2 5例 )术后使用自体引流血回输装置 ,对照组 ( 2 5例 )使用负压吸引球。记录引流 /回输血量及与输血有关的反应。结果 :实验组平均回输引流血 492 ml,未输库血 ,也未发现输血反应及菌血症。对照组平均术后输库血 40 0 ml。二组患者手术前后的血红蛋白无显著差异。结论 :自体引流血回输是全关节置换术后安全有效的补充术后失血的方法。在术前没有自体血储备的情况下 ,该技术减少了输注库血的机会 。

Objective: To determine the clinical efficacy and safety of a postoperative wound drainage autotransfusion system. Methods: Fifty patients of 2 groups underwent primary total hip or total knee arthroplasty were examined in a prospective controlled study. The experimental group (25 cases) received autotransfusion drainage system, the control group (25 cases) received common vacuum drainage system without autotransfusion. The drainage/reinfusion, blood transfusion, the reactions associated blood loss and blood transfusion were recorded for analysis. Results: In experimental group, no coagulopathies, transfusion reactions, or sepses were associated with autotransfusion, which averaged at 492 ml. In the control group, blood transfusion has been 400 ml in average. There were no significant differences between 2 groups in preoperative and postoperative hemoglobins and hematocrits. Conclusion: Drainage autotransfusion system is safe and effective in the management of primary total arthroplasty patients. Postoperative reinfusion of filtered salvaged blood is associated with decreased prevalence of homologous transfusion after total joint replacement, especially the total knee replacement and bilateral total joint replacement among patients properatively donated autologous blood is not available.