血小板分离联合自体血回输在神经外科手术中的应用研究

Study on application of autologous plateletpheresis combined with autologous blood transfusion in neurosurgery

目的探讨血小板分离联合自体血回输在神经外科手术中的应用效果。方法60例神经外科手术患者,随机分为A组及B组,每组30例。A组患者术中输入异体血和血浆,B组患者术中给予血小板分离联合自体血回输。比较两组患者麻醉诱导前(T0)、异体血输血(A组)或自体血及血小板回输(B组)前15 min(T1)、异体血输血(A组)或自体血及血小板回输(B组)后24 h(T2)时的血红蛋白(Hb)、红细胞压积(HCT)、血小板计数(PLT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)水平。结果两组患者T0、T1时的Hb、HCT、PLT、APTT、PT水平及T2时的Hb、HCT水平比较,差异均无统计学意义(P>0.05)。两组患者T1时的Hb、HCT、PLT水平低于T0时,APTT、PT水平长于T0时,差异具有统计学意义(P<0.05)。两组患者T2时的Hb、HCT水平高于T1时,B组患者T2时的PLT水平高于T1时,APTT、PT水平短于T1时,差异具有统计学意义(P<0.05);A组患者T2时的PLT、APTT、PT水平与T1时比较,差异无统计学意义(P>0.05)。B组患者T2时的PLT(174±56)×109/L高于A组的(135±42)×109/L,APTT(32±3)s、PT(13.2±0.6)s短于A组的(38±4)、(15.9±0.8)s,差异具有统计学意义(P<0.05)。结论血小板分离联合自体血回输在神经外科手术中较异体血回输能更早的恢复患者的凝血功能。

Objective To discuss the practical effect of autologous plateletpheresis combined with autologous blood transfusion in neurosurgery.Methods A total of 60 cases of neurosurgical patients were randomly divided into group A and group B,with 30 cases in each group.Patients in group A received allogeneic transfusion and plasma,and patients in group B received autologous plateletpheresis and autologous blood transfusion.The hemoglobin(Hb),hematocrit(HCT),platelet count(PLT),activated partial thromboplastin time(APTT),prothrombin time(PT)before induction of anesthesia(T0),15 min before allogeneic blood transfusion(group A)or autologous blood and platelet transfusion(group B)(T1),24 h after allogeneic blood transfusion(group A)or autologous blood and platelet transfusion(group B)(T2)between the two groups.Results There was no statistically significant difference in levels of Hb,HCT,PLT,APTT and PT at T0 and T1,and levels of Hb and HCT at T2 between the two groups(P>0.05).The levels of Hb,HCT and PLT at T1 of the two groups were lower than those at T0,and APTT and PT were longer than those at T0.All the difference was statistically significant(P<0.05).The levels of Hb and HCT at T2 of the two groups were higher than those at T1;the PLT level at T2 was higher than that at T1,and APTT and PT were shorter than those at T1.All the difference was statistically significant(P<0.05).In group A,there was no statistically significant difference in levels of PLT,APTT and PT at T2 compared with those at T1(P>0.05).At T2,the PLT(174±56)×109/L of group B was higher than(135±42)×109/L of group A,and APTT(32±3)s and PT(13.2±0.6)s were shorter than(38±4)and(15.9±0.8)s of group A.All the difference was statistically significant(P<0.05).Conclusion Combination of autologous plateletpheresis and autologous blood transfusion in neurosurgery can restore blood coagulation function of patients earlier.