大量输入悬浮红细胞与经血液回收机处理悬浮红细胞在全身麻醉手术患者中的应用及对患者凝血功能的影响

Application of massive infusion of suspended red blood cells and treatment of suspended red blood cells by blood recovery machine in patients undergoing general anesthesia and its effect on their coagulation function

目的探究大量输入悬浮红细胞与经血液回收机处理悬浮红细胞在全身麻醉手术患者中的应用及对患者凝血功能的影响。方法选取我院2015年2月～2016年7月期间收治的在临床中需要进行大量输注悬浮红细胞的全身麻醉手术的患者60例,随机将其分成两组。其中一组为研究组,将对需要输血的患者使用经血液回收机处理过的悬浮红细胞输入;另一组为对照组,将对需要输血的患者大量输入悬浮红细胞。对比两组输入方式对患者产生的不同效果以及对患者凝血功能的影响。结果治疗后两组患者PT、APTT、FIB以及TT等指标均显著低于治疗前,且研究组患者显著低于对照组(P<0.05);研究组患者菌血症、细菌感染及破裂出血等不良反应发生情况方面显著少于对照组(P<0.05);研究组患者下床活动时间、住院天数及手术出血量均显著低于对照组(P<0.05)。结论对需要进行大量输血并进行全身麻醉手术的患者采取使用经血液回收机处理悬浮红细胞输入的方式在临床上的使用效果较好于大量输入悬浮红细胞的方法,应用也较为广泛,对患者的凝血功能造成的影响也相对较小,是一种安全有效的临床应用方案,值得在实际临床操作中大力推广使用。

Objective To investigate the application of massive infusion of suspended red blood cells and the treatment of suspended red blood cells by blood recovery machine in the patients undergoing general anesthesia and its effects on coagulation function. Methods 60 patients who underwent general anesthesia and were in need of massive infusion of suspended red blood cells clinically in our hospital from February 2015 to July 2016 were selected in the study, and they were randomly divided into two groups. One group was the study group, and the patients in need of blood transfusion were given the infusion of red blood cells processed by the blood recovery machine; the other group was the control group, and the patients in need of blood transfusion were given massive infusion of suspended red blood cells. The different effects of the two infusion methods on the patients and the effect on the patient＇s coagulation function. Results After treatment, the PT, APTT, FIB and TT indexes of the two groups were significantly lower than those before treatment, and the study group was significantly lower than the control group（P〈0.05）; the incidence rate of adverse reactions such as bacteremia, bacterial infection and rupture of bleeding in the study group was significantly lower than that in the control group（P〈0.05）; the time of off-bed activity, the number of hospital stays, and the amount of surgical bleeding in the study group were significantly lower than those in the control group（P〈0.05）. Conclusion For patients who need massive blood transfusions and undergo general anesthesia, the method of using the blood recovery machine to process the infusion of suspended red blood cell is better in clinical use than the massive infusion of red blood cells, and the applications are also more extensive. The impact on the patient＇s coagulation function is also relatively small. It is a safe and effective clinical application program, which is worthy of widespread promotion and application in actual clinical operations.