自体血液回收技术在非体外循环冠状动脉旁路移植术中的应用

Application of Cell Saver in OPCAB

目的 探讨自体血液回收（Cell Saver）技术在非体外循环冠状动脉旁路移植术（OPCAB）中应用的临床效果.方法 96例OPCAB患者分为两组：应用Cell Saver技术组（试验组）和不应用Cell Saver技术组（对照组）,每组各48例.比较术后24h两组红细胞计数（RBC）、血红蛋白量（Hb）、红细胞比容（Hct）、血小板计数（PLA）、术后引流量、输异体血量的差异及术后不良反应情况.结果 术后24h试验组、对照组RBC分别为（3.6±0.5）×10^12/L和（3.5±0.7）×10^12/L,Hb分别为（111±12）g/L和（110±10）g/L,Hct分别为0.33±0.04和0.32±0.04,PLA分别为（119±21）×10^9/L和（116±23）×10^9/L;术后引流量分别为（385±45）ml和（378±57）ml,两组比较均未见统计学差异（P＞0.05）.输异体血量分别为（95±13）ml和（424±58）ml;输血后不良反应发生例数6例和21例.本组试验数据显示,术后24h两组RBC、Hb、Hct、PLA及术后引流量比较未见统计学差异（P＞0.05）;输异体血量两组比较差异有统计学意义（P＜0.05）;输血后不良反应发生率两组差异显著（P＜0.05）.结论 在OPCAB术中应用Cell Saver技术能显著减少输异体血量,并因此减少相应输血不良反应,具有良好的经济效益及社会效益.

Objective To compare the clinical effect of Cell Saver in OPCAB.Methods 96 cases of OPCAB patients were divided into two groups：Cell Saver group（n=48） and no Cell Saver（n=48）.The red blood cell count （RBC）,hemoglobin （Hb）,hematocrit （Hct）,platelet count （PLA）,postoperative drainage,transfused heterogenous blood and adverse reactions between two groups after operation 24 hours were compared.Results Twenty-four hours after operation in the experimental group and control group,RBC were respective （3.6±0.5）× 10^12/L vs （3.5±0.7）×10^12/L,Hb were respective（111±12）g/L vs （110±10）g/L,Hct were respective 0.33±0.04 vs 0.32±0.04,and PLA were respective（119±21）×10^9/L vs （116±23）×10^9/L respectively;postoperative drainage were （385±45）ml vs （378±57）ml.The experimental group compared with the control group：the blood transfusion volume was （95±13）ml vs （424±58）rnl,the incidence of adverse reactions after transfusion was 6 cases vs 21 cases.There were no significant differences between the two groups in postoperative RBC,Hb,Hct,PLA,and the volume of drainage （P〉0.05）,while the volume of transfused heterogenous blood and adverse reactions were significantly different（P〈0.05）.Conclusion Using Cell Saver in OPCAB,the heterogenous blood transfusion and adverse reactions can be reduced obviously,with good economic and social benefits.