自体输血对心脏外科手术病人血小板白细胞及纤溶系统的影响

Effect of autotransfusion on fibrinolysis, platelet and leukocyte cell activation during open heart surgery

目的 探讨自体输血对心脏直视手术病人血小板、白细胞及纤溶系统的影响。方法 2 4例体外循环心脏手术病人分为两组 ,试验组 11例 ,接受自体红细胞洗涤回输 ;对照组 13例 ,不接受自体血细胞洗涤回输。于术前、血液洗涤前、洗涤后即刻、回ICU后 3h、12h测定纤维蛋白原、D 二聚体 (D D)、血栓素A2 (TXA2 )、白介素 (IL) 6、IL 8。结果 术后两组间纤维蛋白原、D D、TXA2 、IL 6、IL 8等指标差异无统计学意义。结论 心脏直视手术过程中 ,自体血液洗涤不会进一步激活血小板。

Objective: To observe whether further activation on fibrinolysis, platelet and leukocyte could be induced by reinfusion of washed shed blood during open heart surgery. Methods: 24 patients were randomly assigned into two groups. Group I consists of 11 patients, who underwent open heart surgery with extracorporeal circulation (ECC) and received salvaged blood. Group II consists of 13 patients, served as control without receiving autotransfusion. Fibrinogen, D dimer, TXA 2, IL 6,IL 8 were measured at different time. Results: There was no statistical significance of fibrinogen, D dimer, TXA 2, IL 6, IL 8 at each time point between the two groups.Conclusion: We concluded that fibrinolytic pathway, platelet and leukocyte were activated by ECC and autotransfusion, but no aggravative effect was induced by autotransfusion alone.