血液回收技术对婴幼儿心脏外科术后临床结果的影响

Effects of cell saver on blood transition and post-operative clinical outcome for pediatric patients undergoing cardiac surgery

目的评价心脏矫治术期间使用血液回收(CS)技术处理回输术中出血及体外循环(CPB)管路余血对心脏外科患儿节约用血的意义和对临床结果的影响。方法根据术中是否使用CS,将100例在CPB下行先天性心脏病矫治术的患儿随机分为两组:洗血球组(CS组,n=50)和对照组(CON组,n=50)。记录两组患儿围术期红细胞比容(Hct),术后输入洗涤红细胞(RBCs)、血浆及血小板量,术后肝肾功能,术后24 h胸腔引流量,升压药使用时间和机械通气时间、ICU时间和住院时间,并进行统计学分析。结果两组患儿均痊愈出院。术后输入库血量及术后输血率CS组均明显低于CON组(P<0.05)。术后升压药使用时间CS组明显低于CON组(P<0.05)。两组患儿其余指标及术后恢复情况无明显差异(P>0.05)。结论对先天性心脏病婴幼儿手术期间使用CS处理术中出血和CPB管路余血可以明显减少术后输血量以及输血患儿的比率,达到节约用血的目的。

Objective To evaluate whether cell saver used in pediatric patients undergoing cardiac surgery would decrease the number of post-operative allogeneic RBCs transfusions and possibly improve the clinical outcomes. Methods A total of 100 pediatric patients with congenital heart disease received elective cardiac surgery in our hospital from Aug. 2014 to Dec. 2014 were studied. Subjects were randomized to a cell saver transfusion group where cell saver blood was available for transfusion up to the end of the operation,or to a control group,n = 50 in each group. Blood product transfusions,and clinical outcomes were compared between groups.Results Children randomized to the cell saver group had significantly fewer RBC transfusions（ P〈0. 05）,and significantly fewer donor exposures（ P〈0. 05）. There were no significant clinical outcome differences. Conclusion Cell saver can reduce post-operative allogeneic RBC transfusion in pediatric patients undergoing cardiac surgery.