少白细胞红细胞与普通悬浮红细胞在心脏瓣膜手术中应用的比较

Comparison of the application of leukocyte-reduced red blood cell suspension and ordinary red blood cell suspension in patients undergoing heart valvular surgery

目的比较少白细胞红细胞与普通悬浮红细胞在心脏瓣膜手术患者输注效果及对预后的影响。方法305例需输血治疗的体外循环心脏瓣膜置换手术患者,随机分为少白细胞红细胞组(160例)和悬浮红细胞组(145例)。少白细胞红细胞组患者只接受少白细胞红细胞的输注,悬浮红细胞组患者只接受普通悬浮红细胞的输注。少白细胞红细胞与普通悬浮红细胞均由北京市红十字血液中心提供。观察指标:红细胞和血浆输注量,白细胞计数,血红蛋白水平,术后机械通气时间,术后住院时间和住院费用。结果两组患者间一般情况比较差异无统计学意义(P>0.05);红细胞输注量和血浆输注量两组间比较差异无统计学意义(P>0.05);手术前后血红蛋白水平和白细胞计数两组间比较差异无统计学意义(P>0.05)。两组患者术后白细胞计数比术前均显著增加(P<0.01),但两组间比较差异无统计学意义(P>0.05)。少白细胞红细胞组患者手术后机械通气时间缩短(33.8±21.9)h与(49.1±31.2)h,P<0.05,术后住院时间减少(8.2±2.5)d与(9.1±4.7)d,P<0.05,住院费用减低(7.4±2.1)万元与(8.0±3.4)万元,P<0.05。结论与输入普通悬浮红细胞相比,体外循环心脏瓣膜手术患者输入少白细胞红细胞有利于术后早期恢复,缩短住院时间,减少住院费用。

Objective To compare the effects of leukocyte-reduced red blood cell suspension and ordinary red blood cell suspension transfusion in patients undergoing heart valve surgery and the impact on prognosis.Methods 305 cases of patients undergoing heart valve replacement surgery with cardiopulmonary bypass which required transfusion therapy were randomly assigned into two groups： leukocyte-reduced red blood cell group suspension（160 cases） and red blood cell suspension group（145 cases）.Patients who required transfusion therapy perioperatively either received leukocyte-reduced red blood cell suspension or ordinary red blood cell suspension.Leukocyte-reduced and ordinary red blood cell suspension were supplied by the Beijing Red Cross Blood Center.The outcomes were measured on the following parameters： red blood cell and plasma volume,white blood cell count,hemoglobin levels,duration of mechanical ventilation and length of stay postoperatively and hospitalization expenses.Results There was no statistically significant difference in the general conditions between the two groups（P0.05）,the volume of red blood cell and plasma transfusion between the two groups（P0.05）,the preoperative and postoperative of hemoglobin levels,and the preoperative white blood cell count between the two groups（P0.05）.Compared to preoperative condition,the white blood cell count significant increased postoperatively in both groups（P0.01）,but there was no statistically significant difference between two groups（P0.05）.The duration of mechanical ventilation postoperatively in leukocyte-reduced group was shortened（33.8±21.9）h and（49.1±31.2） h,P 0.05,the length of stay after surgery was reduced（8.2±2.5） d and（9.1±4.7） d,P0.05,and total hospitalization expenses were reduced（7.4±2.1） × 104 Yuan and（8.0±3.4） × 104 Yuan,P0.05.Conclusion Compared with ordinary red blood cells suspension transfusion,the application of leukocyte-reduced red blood cell transfusion is conducive to early postoperative recovery of patients undergoing heart valve surgery under cardiopulmonary bypass,and can reduce the length of stay after surgery and total hospitalization expenses.