回收式自体输血的临床应用

Application of reclimed autotransfusion

目的 探讨回收式自体输血和血浆代用品对择期性大手术出血及急诊大出血手术病例的生命体征及Hct、Hb、SPO2 、CVP变化的影响。方法 选择脊柱、股骨、异位妊娠出血、肝脾破裂、血气胸、大动脉损伤手术病人 60例 ,采用国产ZZ 2 0 0 0自体型血液回收机。经过抗凝、回收、洗涤、浓缩、净化处理后回输给病人。分别于术前、术中、术后监测SBP、DBP、MAP、P、SPO2 、HCt、Hb、CVP的变化值。结果 各项指标实验检测结果显示急诊病例与术前比较及术前择期病例与术前急诊病人比较均有显著差异 (P <0 0 1 )。结论 回收式自体血液回输在择期手术大出血和急性大失血病人的抢救中具有很好的作用 ,既避免了血源紧张 ,又预防了因输异体血液所致的输血疾病及输血反应 。

Objective To investigate the effect of reclaimed autotransfusion and plasma substitute on some vital signs of patients with the massive bleeding during selective and emergent operation. Methods A homemade Cell Saver type 2000 was employed for autotransfusion Sixty patients with massive bleeding in the operations of the spine, the femur, bleed due to ectopic pregnancy, hepatic or pancreatic ruptures, hemopneumothorax and injury of large arteries were autotransfused by this apparatus. The hemorrhagic blood was transfused back to the patients after anticoagulation, collection, rinse, condense, and purification. Changes of SBP, DBP, MAP, P, SPO 2, HCt, Hb, and CVP were determined before, during and after the operation. Results All parameters were significantly different before, during and after operation. Conclusion Collected autoransfusion plays an important role in patients with massive bleeding during selective and emergent operation, which solving the problem of lack of blood storage, and preventing the incidence of disorders and reactions due to allotransfusion. It should be suggested to apply in clinic to improve the safety of transfusion and successful rate of rescue.