贮存式自体输血在髋关节置换术中的应用

The application of preoperative autologous blood storage and transfusion for hip replacement

目的探讨贮存式自体输血和异体输血对髋关节置换术患者手术及术后恢复的临床应用效果。方法将台州医院2013—2014年181例髋关节置换术患者分为自体血组（n=100）和异体血组（n=81）,对2组患者的手术前后各项血液指标进行分析。结果术后3 d自体血组的血小板分布宽度明显低于异体血组（P〈0.05）,其他血常规、凝血指标指标均无明显差异（P〉0.05）;异体血组术后3 d丙氨酸氨基转移酶、天冬氨酸氨基转移酶明显高于自体血组（P〈0.05）;异体血组术后1 d前白蛋白明显低于自体血组（P〈0.05）,术后3 d总蛋白、白蛋白明显低于自体血组（P〈0.05）;异体血组腺苷脱氨酶术后1 d、术后3 d明显高于自体血组（P〈0.05）;自体血组的出血量、输血量明显低于异体血组,差异有统计学意义（P〈0.05）。结论贮存式自体输血是1种安全、有效的输血方式,可避免大多数关节置换术中输注异体血带来的潜在危险,又节约了血液资源,值得在临床推广。

Objective To explore the clinical application effects of preoperative autologous blood storage/transfusion and allogeneic blood transfusion on patients undergoing hip replacement and their postoperative recovery. Methods 181 patients undergoing hip replacement from 2013 to 2014 in Taizhou hospital were divided into the autologous blood group（ n = 100 cases） and the allogeneic blood group（ n = 81 cases）. The blood indexes before and after operation were analyzed. Results The platelet distribution width of the autologous blood group was significantly lower than that of the allogeneic blood group at3 days after operation（ P〈0. 05）. No significant differences in other blood routine and coagulation indexes（ P〈0. 05） were found; The levels of alanine and aspartate aminotransferase in the allogeneic blood group were significantly higher than those in the autologous blood group at 3 days post operation（ P〈0. 05）; The allogeneic blood group showed a significantly lower prealbumin level at 1 day post operation（ P〈0. 05） and had significantly lower total protein and albumin levels at 3 days post operation as well（ P〈0. 05）; The levels of adenosine deaminase in the allogeneic blood group were significantly higher than those in the autologous blood group both at 1 day and 3 days post operation（ P〈0. 05）; The amount of bleeding and blood loss of the autologous blood group were significantly lower than those of the allogeneic blood group（ P〈0. 05）. Conclusion Preoperative autologous blood storage and transfusion is a safe and effective way of blood transfusion,which can avoid the potential risks of allogeneic transfusion in most joint replacement operations and save blood resources. The application of which is worth promoting.