骨科术后伤口渗血回输的时间选择

Clinical Study of the Risk of Reinfusion of Postoperative Drain Blood in Orthopaedics

目的 :选择骨科术后伤口渗血可回输的时间。方法 :收集 2 0例患者术后 2h ,4h ,6h ,12h ,2 4h ,48h伤口渗血及处理血标本 ,检测其血常规、血气分析、细菌培养指标。结果 :术后 6h为明显的时间点 ,在此之前 ,血液质量较高 ,回输后引起的风险较低。术后伤口渗血约 6 0 %集中在术后 6h内 ,伤口渗血中血红蛋白随时间逐渐降低 ,至术后 6h降至 8g·L-1。血小板始终低于正常 ,白细胞早期低于正常 ,术后 6h后反应性升高。处理血的PH值呈酸性 ,渗血和处理血中的血糖都进行性下降 ,渗血和处理血的细菌培养均为阴性 ,渗血中的肿瘤坏死因子术后 6h开始升高。结论 :术后 6h以内的伤口渗血质量较高 ,安全 ,而对术后 6h后的伤口渗血应慎重回输 ,否则有引发凝血疾病。

Objective: To observe the volume, blood routine, blood gas analysis and tumor necrosis factor of postoperative drain blood, in order to supply clinical data for the reinfusion of drain blood. Methods: By collecting 20 patients' specimen of drain blood and reinfused blood at different time, we detect blood routine, blood gas analysis and bacteria culture. Results: about 60% of drain blood concentrate within 6 hours of postoperation, the haemoglogin and glucose of both drain blood and reinfused blood is decreased progressively, platelet and WBC is below the normal, but WBC was increased later, TNF become elevated after 6 hours of postoperation. Conclusion: The reinfusion of postoperative drain blood is safe and effective because of the growing metabolic products of drain blood, the risk become high with the time prolong and the transfusion enlargement.