自血回输对脊椎手术患者小肠微循环的影响

Effect of Autogenous Blood Salvage on Microcirculation of Small Intestine in Patients Undergo-ing Spine Surgery

【目的】观察自体血液回收应用于脊椎外科手术时血液保护效果及对小肠微循环的影响。【方法】40例ASA Ⅰ～Ⅱ级择期在全麻下行脊椎手术患者随机均分为自体血回输组（Ⅰ组）和异体血输注组（Ⅱ组）。记录两组患者术中失血量、异体血输注量及全麻诱导插管前（T1）、诱导结束后30min（T2）、术毕（T3）、术后24h（T4）的肠脂肪酸结合蛋白（I-FABP）和D-乳酸表达。【结果】与Ⅰ组比较，Ⅱ组异体血输注量增多，Ⅱ组在T3、T4时点I-FABP与D-乳酸表达增高。【结论】自体血液回输可以有效减少脊椎手术异体血的输注，对小肠微循环灌注影响小。

[Objective]To observe the effect of autogenous blood salvage （BS ） on blood protection and small intestinal microcirculation in patients undergoing spine surgery .[Methods] A total 40 ASA Ⅰ ～ Ⅱ patients scheduled for spine surgery under general anesthesia were randomly divided into autogenous BS group （group Ⅰ） and xenogenous blood transfusion group（group Ⅱ） .Blood loss ,xenogenous blood transfusion volume and the expressions of intestinal fatty acid binding protein （I-FABP） and Dlactate before operation （T1 ） , 30min after tracheal intubation（T2 ） ,at the end of operation（T3 ） and 24h after operation（T4 ） were recorded in two groups .[Results]Compared with group Ⅰ ,xenogenous blood transfusion volume in group Ⅱ increased and the expressions of I-FABP and D-lactate in group Ⅱ at T3 and T4 time points increased .[Conclusion]Autogenous BS can effectively reduce xenogenous blood transfusion during spine surgery ,and has less effect on small intestinal microcirculation perfusion .