自体血液回输对全麻手术患者免疫状态及感染的影响研究

Influence of autologous blood transfusion on immune state and infection in patients undergoing general anesthesia surgery

目的观察与研究自体血液回输对全麻手术患者免疫状态及感染的影响情况,了解自体血液回输在临床中的应用价值。方法选取2015年12月-2016年6月于医院进行全麻手术54例患者为研究对象,根据随机数字表法分为对照组和观察组,各27例,对照组进行异体输血,观察组进行自体血液回输,检测及比较两组患者术前及术后不同时间的外周血T淋巴细胞亚群、红细胞免疫状态及术后感染率。结果观察组术后感染率明显低于对照组(P<0.05);术后不同时间两组CD3+CD4+、CD4/CD8、CD3+及CD4+均呈现先升后降的趋势,而CD8+则呈现先降后升的趋势,且术后2d及5d时观察组CD3+CD4+、CD4/CD8、CD3+及CD4+均高于对照组,CD8+则低于对照组(P<0.05);RBC-C3bR、FEER、ATER及NTER表达水平均呈现先降后升的状态,FEIR则呈现先升后降的趋势,且术后2d及5d时观察组RBC-C3bR、FEER、ATER及NTER均高于对照组,FEIR则低于对照组(P<0.05)。结论自体血液回输对全麻手术患者免疫状态的影响相对好于异体输血,对患者术后感染具有积极的控制作用,自体血液回输的临床应用价值较高。

OBJECTIVE To observe the influence of autologous blood transfusion on immune state and infection in patients undergoing general anesthesia surgery and understand the clinical application value of the autologous blood transfusion. METHODS A total of 54 patients who underwent the general anesthesia surgery in the hospital from Dec 2015 to Jun 2016 were recruited as the study objects and randomly divided into the control group and the ob- servation group, with 27 cases in each group. The control group was given allogeneic blood transfusion, and the observation group was treated with autologous blood transfusion. The peripheral blood T lymphocyte subsets, e- rythrocyte immune state, and incidence of postoperative infection were observed and compared between the two groups of patients before and after the surgery. RESULTS The incidence of postoperative infection was significantly lower in the observation group than in the control group （P（0.05）. CD3 ＋ CD4 ＋ , CD~/CD8, CD3 ＋ , and CD4 ＋ were firstly increased and then were decreased after the surgery for different time periods, however, CD8 ＋ was firstly decreased and then was increased. CD3 ＋ CD4 ＋ , CD4/CD8 , CD3 ＋ , and CD4 ＋ were higher in the observation group than in the control group after the surgery for 2 and 5 days, while the CDS＋ of the observation group was lower than that of the control group （P〈0.05）. The levels of expression of RBC-C3bR , FEER, ATER and NT- ER dropped firstly and then elevated, while the FEIR elevated firstly and then dropped the RBC-C3hR, FEER, ATER, and NTER were higher in the observation group than in the control group, while the FEIR of the observation group was lower than that of the control group （P〈0.05）. CONCLUSION The autologous blood transfusion has better effect on the immune state of the patients undergoing general anesthesia surgery than the allogeneic blood transfusion, it has positive role in control of the postoperative infection, therefore, the autologous blood transfusion has higher clinical application value.