回收式自体输血对脊柱外科围手术期出凝血与血携氧功能的影响

Effects of Autologous Transfusion Salvage on the Condition of Coagulation and the Ability of Blood to Carry Oxygen during the Perioperative Period in Spinal Surgery

目的 观察回收式自体输血 (ATS)在脊柱外科手术中的应用及其对围手术期几项血液指标的影响。方法 将 62例脊柱损伤患者 ,按手术种类分为 5组 ,分别测定术前、术后 1d、术后 7d血液中Hb、HCT、PaO2 、Fbg、PLT、PT ,比较各组ATS量的变化及其对出凝血状况和血携氧功能的影响。结果 回输自体血量 52 860ml,占总输血量的 80 . 2 6 %。术后Hb、HCT、PLT均不同程度减少 ,PT显著延长 (P <0 . 0 1 ) ,Fbg无明显变化 ,PaO2 显著升高 (P <0 . 0 1 )。结论 围手术期虽有轻度贫血但不影响血携氧功能 ,术后PT显著延长却未出现出凝血功能障碍 ,ATS技术能明显减少异体血用量 。

Objective To observe the clinical usage and effects on some blood parameters of autologus transfusion salvage (ATS).Methods Sixty two patients with spinal injury were divided into five groups according to operative types,and their blood Hb,HCT,PaO 2,Fbg,Plt and PT were measured exactly 1 day preoperative and 7 days postoperative.Blood volume of ATS in each group was calculated and its effects on the conditions of coagulation and abilities of blood to carry oxygen were compared with each other.Results Blood volume of ATS was 52860ml,and this was 80.26% in total blood transfusion during the operative periods.The Hb,HCT and Plt were decreased in different stages after operation.PT was delayed significantly (P<0.01). PaO 2 was increased markedly (P<0.01). There was no changes in Fbg .Conclusion There was mild anemia during the perioperative period but did not affect the abilities of blood to carry oxygen. There was no decrease of the blood coagulative function though PT marked delayed after surgery.ATS markedly decreased the volume of blood transfusion .This suggeste that the clinical usage of ATS might be effective and saft in the spinal surgery.