预存自体血回输在腰椎滑脱手术中的临床观察

Clinical Observation of Predeposited Autologous Blood Transfusion in Operation for Lumbar Spondylolisthesis

目的:探讨预存自体血回输应用于腰椎滑脱手术的临床疗效、不良反应及应用价值。方法:选择80例因单节段腰椎滑脱接受腰椎后路减压、椎体复位、椎间植骨融合、椎弓根螺钉内固定手术并输血治疗的患者,其中预存自体血回输的患者40例作为A组,因拒绝术前预存自体血而输注异体血的40例患者作为B组,记录并比较两组患者的手术时间、术中失血量、术后引流量和输血量、血常规观察指标(红细胞、血红蛋白、红细胞比容)及输血相关不良反应。结果:两组的手术时间、术中失血量、术后引流量和输血量比较差异均无统计学意义(P>0.05);两组不良反应比较差异有统计学意义(P<0.05);两组输血后第1天血常规各观察指标降低,与输血前比较差异有统计学意义(P<0.05),两组间比较差异无统计学意义(P>0.05);两组输血后第7天血常规各观察指标比较差异均有统计学意义(P<0.05)。结论:对腰椎滑脱手术患者来说,采用术前预存自体血回输及异体输血均能有效纠正术中术后失血性贫血,但术前预存自体血回输能降低输血不良反应发生率,输血后患者血常规各观察指标恢复更快,在当前异体血供血困难的前提下,术前预存自体血回输是一种值得临床推广的方法。

Objective：To explore the clinical efficacy,adverse reaction and application value of predeposited autologous blood transfusion used in operation for lumbar spondylolisthesis.Method：80 patients with single segmental lumbar spondylolisthesis who had received posterior lumbar decompression,vertebral reduction,interbody fusion and pedicle screw internal fixation operation and transfusion therapy were selected,the 40patients who received autologous blood transfusion were set up the group A,at the same time,40 patients who refused to preoperative autologous blood were given allogeneic blood transfusion were set up the group B. The operation time,intraoperative blood loss,postoperative drainage volume,the volume of blood transfusion,blood routine indexes（red blood cell,hemoglobin,hematocrit） and the adverse transfusion reaction of two groups were compared. Result：The operation time,intraoperative blood loss,postoperative drainage volume and the volume of blood transfusion of two groups were compared,the differences were not statistically significant（P〉0.05）. Adverse reactions of two groups,the difference was statistically significant （P〈0.05）. First day after blood transfusion,the observed indexes of blood routine decreased,the difference before and after transfusion was statistically significant（P〈0.05）,but no statistically significant difference between the two groups （P〉0.05）. The red blood cell,hemoglobin,hematocrit of two groups in 7 days after transfusion were compared ot the two group,the difference were statistically significant（P〈0.05）.Conclusion：For patients with lumbar spondylolisthesis operation,the use of preoperative autologous blood and allogeneic blood can effectively correct postoperative blood loss anemia,but preoperative autologousblood can reduce the incidence of adverse transfusion reaction,the red blood cell, hemoglobin and hematocrit of patient recovery faster after autotransfusion.In the premise of the allogeneic blood supply difficulties,preoperative autologous blood transfusion is a method which is worthy of clinical application.