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自体血回输对高龄脊柱手术患者凝血功能及乳酸代谢的影响 被引量：13

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摘要 目的探讨自体血回输对高龄脊柱手术患者凝血功能及乳酸代谢的影响。方法选择脊柱骨科手术高龄患者60例,随机分为自体血回输组(R组)和对照组(C组),每组30例。R组术中应用自体血液回收机进行血液收集、回输,术中经自体血回输仍不能维持血液动力学稳定时,可输注同种异体血,C组不进行自体血回输,直接输注同种异体血。分别于手术前(T1)、输血前(T2)、输血后30 min(T3)、术后24 h(T4)观察其血红蛋白(HB)、红细胞压积(HCT)、血小板(PLT)及乳酸(Lac)变化;同时测定凝血酶原时间(PT)、部分活化凝血酶时间(APTT)、纤维蛋白原(FIB)变化;准确评估术中失血量、补液量、输血量,尿量及输血并发症情况。结果输注异体浓缩红细胞量及血浆用量:R组分别为(1.44±0.21)U和(137.51±39.94)ml,而C组分别为(2.83±0.42)U和(255.42±31.34)ml,2组相比差异有统计学意义(P<0.05);2组各时点的凝血指标的变化趋势基本一致,差异无统计学意义(P>0.05);2组血乳酸相比,R组T3和T4时血乳酸均低于C组,差异有统计学意义(P<0.05)。结论自体血回输可显著减少老年脊柱手术异体血输入,降低术后血乳酸生成,且对术后凝血功能无明显影响,故可安全用于高龄脊柱手术患者。
作者 赵爽 王秀丽 刘飞飞 段卫东 吴川 仝烨峰
机构地区 河北医科大学第三医院麻醉科
出处 《河北医药》 CAS 2016年第9期1374-1377,共4页 Hebei Medical Journal
基金 河北省卫生和计划生育委员会重点学科跟踪项目(编号:GL2014041)
关键词 自体血回输 高龄 脊柱手术 凝血功能 乳酸
分类号 R331.3 [医药卫生—人体生理学]
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参考文献27

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二级参考文献14

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共引文献56

同被引文献117

引证文献13

二级引证文献44

河北医药
2016年 第9期

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