血液回收技术在骨科大手术中的应用

Blood salvage technique in major orthopedic surgery

目的 观察血液回收技术在骨科大手术中应用的作用。方法 40例择期行骨科手术病人配对后随机分为两组。自体血回收组用血液回收仪回收术中失血 ,对照组不回收失血。分别采术前、术毕后 3小时、术后第 1天及术后第 7天的静脉血 ,测定红细胞计数 (RBC)、血红蛋白 (Hb)、血细胞压积 (Hct)、血小板计数 (Pt)、出血时间 (BT)、凝血时间 (CT)、凝血酶原时间 (PT)、白陶土部分凝血活酶时间 (KPTT)、凝血酶时间 (TT)。结果 两组病人异体血输用量有显著差异 (P <0 0 1)。自体血回收组术后第 1天引流量明显少于对照组 (P <0 0 5 ) ,其RBC、Hb于术后第 1天均高于对照组(P <0 0 5 ) ,术毕及术后第 7天两组差别不明显 (P >0 0 5 )。两组Pt和Hct在各测定时点无明显差别 (P >0 0 5 )。自体血回收组术毕的KPTT明显延长 (P <0 0 5 ) ,对照组PT、TT、KPTT均明显延长(P <0 0 5 )。两组病人各测定时点BT、CT均在正常范围。结论 全自动血液回收技术能明显减少异体血用量 。

Objective To observe the efficacy of blood salvage technique used in major orthopedic surgery.Methods Forty patients scheduled for elective major orthopedic surgery were paired according to their sex and kind of surgery.Then two paired patients were randomly divided to either autotransfusion group(group A) or control group (group B).The operative blood was salvaged in group A,while that in group B was not.Red blood cell count(RBC),hemoglobin(Hb),hematocrit(Hct),platelet count(Pt),bleeding time(BT),clotting time(CT),prothrombin time(PT),Kaoline partial thromboplastin time(KPTT) and thrombin time(TT) were recorded in the time points of before operation,3h after operation,on the first and seventh day after operation respectively.Results The volume of homologous blood transfused was significantly different between two groups( P< 0 01).Compared with group B the amount of drained blood in group A was less and RBC count and Hb were significantly higher on the first and the seventh postoperative day( P< 0 05).There was no difference in Pt count and Hct between two groups( P> 0 05).KPTT was significanntly prolonged ( P< 0 05)in group B postoperatively.PT,TT and KPTT,however,were all prolonged significantly( P< 0 05)in group B after surgery.Conclusion Intraoperative blood salvage significantly reduces homologous transfusion and can be used safely in major surgery.