等容稀释性自体输血对骨科老年手术病人凝血和免疫功能的影响

Effect of acute normovolemic hemodilution autotransfusion on coagulation and immunity function in elderly patients receiving orthopedic operation

目的探讨等容稀释性自体输血(ANH)对骨科老年手术病人凝血和免疫功能的影响。方法选取2013年1月至2015年6月我院骨科需手术治疗的老年病人60例,分为ANH组(30例)和异体输血组(30例)。记录2组病人输血前后凝血功能和免疫功能变化情况。结果输血前2组病人凝血功能均有所下降;血液回输1 d后,2组凝血功能基本恢复术前水平。术后3 d,ANH组免疫抑制作用不明显,对照组免疫功能较术前有所下降(P<0.05)。结论 ANH输血方式对骨科老年病人的凝血和免疫功能影响不大,老年病人骨科围手术期ANH输血方式优于异体输血。

Objective To investigate the effect of acute normovolemic hemodilution autotransfusion（ ANH） on coagulation and immune function in the elderly patients receiving orthopedic operation. Methods Thirty cases receiving ANH and thirty cases receiving xenogenous blood transfusion from January 2013 to June 2015 were enrolled in this study. The coagulation and immunity function of two groups were analyzed. Results Before transfusion,the coagulation function in two groups were reduced. One day after transfusion,the coagulation function of two groups were both returned to the preoperative level. Three days after operation, the immunity function showed no significant inhibition in ANH group,while was significantly reduced in control group（ P 0. 05）. Conclusions ANH shows little effect on coagulation and immune function in elderly orthopedic patients. Perioperative ANH transfusion might be better than xenogenous blood transfusion.