储存式自体输血在脊柱外科手术中应用的疗效及安全性研究

The Efficacy and Safety of Preoperative Autologous Blood Donation in Spinal Surgery

目的探讨储存式自体血回输对脊柱外科非肿瘤手术中应用的疗效和安全性。方法回顾分析广州市第一人民医院脊柱外科诊断为非肿瘤脊柱疾病的手术患者134例,分为自体输血组77例,异体输血组57例,记录并比较组间的住院时间、术后血红蛋白的差异、输血相关不良反应率,并分析住院时长以及自体血的节血效果。结果自体输血组术前采血及自体输注过程中无出现相关不良反应。自体输血组和异体输血组相比,输血量((347.85±66.72)mL v.s.(478.88±194.23)mL,P<0.001)、总住院天数(19.3±8.8 v.s.25.4±11.7,P=0.002)和术后住院天数(10.77±5.41 v.s.16.43±8.41,P<0.001)均明显减少;术后1天血红蛋白(115.30±12.94)g/L v.s.(110.35±16.71)g/L,P=0.075)、红细胞比容(0.34±0.03 v.s.0.33±0.05,P=0.088)无明显差异。结论储存式自体输血应用于脊柱外科手术有效且安全,能减少异体血液输血量,缩短住院时间。

Objective To investigate the clinical effect and safety of autologous blood donation before spinal surgery.Methods A restropective analysis was performed on 134 cases of benign spinal diseases in Guangzhou First People’s Hospital.They were divided into autologous blood group(n=77)and allogeneic transfusion group(n=57).The length of hospital stay,hemoglobin(Hb)changes and the transfusion related adverse reactions of two groups were recorded and compared.Results All the patients in autologous blood group had no related adverse reactions during preoperative blood donation and transfusion.Compared to allogeneic transfusion group,blood transfusion volume[(347.85±66.72)mL v.s.(478.88±194.23)mL,P<0.001)],the total length of hospital stay[(19.3±8.8)d v.s.(25.4±11.7)d,P=0.002)]and the length of postoperative hospital stay(10.77±5.41d v.s.16.43±8.41d,P<0.001)were significantly reduced in autologous blood group.There were no significant differences in hemoglobin[(115.30±12.94)g/L v.s.(110.35±16.71)g/L,P=0.075]and hematocrit(0.34±0.03 v.s.0.33±0.05,P=0.088)one day after operation between two groups.Conclusion Preoperative autologous donation is safe and economical in spinal surgery,which could effectively decrease the volume of allogeneic transfusion and the length of hospital stays.