单侧人工全髋关节置换术中自体单采红细胞回输的疗效观察

Curative effect observation of autologous erythropheresis of unilateral total hip arthroplasty

目的观察人工全髋关节置换术(Total Hip Replacement,THR)患者自体单采红细胞的效果,为人工全髋关节置换术提供一种更优化更高效的自体备血思路,推动自体单采红细胞技术在外科手术中推广应用。方法选取行单侧人工全髋关节置换术的16例患者作为研究对象(单采组),其术前进行自体红细胞单采待术中回输,或根据实际需求又输入异体血;选取同期符合单采自体红细胞条件的,但未进行自体红细胞单采而术中只输异体血的18例患者作为对照(对照组)。记录两组患者单采前或术前血常规主要指标、术中出血量、输异体血情况以及术后第一天的血常规主要指标,并统计学分析。结果单采组患者平均输异体红细胞量为(1.56±1.41)U,对照组为(2.67±1.14)U,差异有统计学意义,其余观察指标两组均无统计学差异。结论单采自体红细胞技术应用于THR作为术前备血,可减少术中异体红细胞输注量,而不引起血常规指标的大幅变化和术中出血量的增加,值得临床推广应用。

Objective To provide a more efficient autologous blood preparationstrategy for total hip replacement（THR）and promote the popularization and application of autologous erythropheresis technology in THR surgery.Methods 16 patients underwent unilateral total hip replacement were chosen as the research objects（apheresis group）.These patients treated with preoperative autologous erythropheresis and allogeneic blood for intraoperative transfusion.18 THR patients were chosen randomly who were only transfused allogeneic bloods as control objects（control group）.The data of blood routine in pre-erythropheresis or pre-operation,the intraoperative blood loss,the volume of allogeneic blood transfusion and the first day blood routine postoperation in were collected and analyzed statistically.Results The volume of allogeneic erythrocyte in the apheresis group was（1.56±1.41）U,compared with（2.67±1.14）U of control group,the difference was statistically significant.However,the rest observation index differences were not statistically significant.Conclusion The application of autologous erythropheresis technology in THR which has a large amount of blood preparation could reduce the amount of transfusion of allogeneic erythrocyte,but caused no significant changes in blood routine indicators and intraoperative blood loss,which is worthy to being used for THR surgery.