术中自体血液回收对红细胞电解质、血糖、pH及乳酸水平的影响

Effect of intra-operative autotransfusion on red blood cells electrolyte, blood glucose, lactic acid and pH

目的观察和分析术中自体血液回收对红细胞电解质、血糖、pH及乳酸水平的影响,以指导血液回收技术的应用。方法纳入本研究的40例手术患者均采用自体血液回收技术,检测分析术前动脉血(动脉组)和术中回收血液(回收组)红细胞中的Na^+、K^+、Ca^(2+)、血糖、乳酸及pH水平变化。结果与动脉组比较,回收组红细胞中血糖、K^+、Ca^(2+)浓度显著降低(P<0.001),Na^+浓度显著升高(P<0.001),但乳酸和pH水平无显著变化。结论血糖浓度的降低可能影响红细胞能量代谢,回收血液需及时回输;可通过更换清洗液或血液回输时适当补充损失的离子和稀释过高的离子改变回收血液中电解质浓度。

Objective To guide the application of blood recovery technology by observing and analyzing the environment intraoperative autologous blood recovery. Method 40 patients with intra-operative autotransfusion, preoperative and intraoperative recovery of arterial blood Na~＋, K~＋, Ca^（2＋）, blood glucose lactic acid, p H values were detected and analyzed. Result Compared with artery group, the concentration of blood glucose, K~＋, Ca^（2＋） were significantly reduced（P 0.001）, the concentration of Na＋ was significantly higher in salvaged group（P 0.001）, lactic acid and p H had no significant difference between the two groups（P〈0.05）. Conclusion Recycling blood cell has low blood sugar levels, which may affect red blood cell energy metabolism, so the recycling blood should be promptly returned to the patients. The electrolytes of recycling blood has some changes, but there is no significant difference in lactic acid and p H value. It can be corrected by changing cleaning fluid or appropriate to add the loss of ions and to dilute excessive ions.