采用综合节血措施行体外循环心脏手术(附322例报告)

BLOOD-SAVING MEASURES USED IN CARDIAC OPERATIONS ON 322 CASES UNDER EXTRACORPOREAL CIRCULATION

目的 探讨节血措施 ,开展血液保护 ,达到围手术期不输库血。方法 采用无血预充、急性等容血液稀释、自体放血、机器血回收、应用抑肽酶、控制血压、微创手术切口的综合措施。结果 119例手术未输血 ,占同期 32 2例手术的 36 .90 %。体外循环转机时间 2 7～ 136min ,平均 5 6min。术后 2 4h引流总量 5 0～ 6 2 0ml,平均 310ml。平均住院 16d ,全部康复出院。出院时血红蛋白均超过 110 g/L ,红细胞压积大于 33%。与对照组相比 ,每例患者平均节约血 980ml,随访 5～ 2 9个月 ,无肝炎等并发症发生。结论 采用综合节血措施开展血液保护是一种安全、可行、有效的方法 ,既节省了费用 。

Objective To explore comprehensive measures to save blood,prevent blood pollution and avoid perioperative blood transfusion.Methods Comprehensive blood saving measures,such as exsanguine precongestion,acute isovolumetric dilution,self fleam,blood recovery from equipment,use of trasylol,blood pressure control and microtraumatic incision were taken in the perioperative stages.Results 36.96%(119 cases ) of the 322 cases in the experimental group received no blood transfusion.The total drainage volumes in 24 hours after operation ranged from 50 to 620ml,the average was 310ml.When patients were discharged,their contents of hemoglobin were all above 110g/L,their packet cell volumes were all larger than 33% and the average saved blood volume was 980ml.No such complications as hepatitis occurred after operation.Conclusion Comprehensive blood saving measures have proved to be safe and effective,and they can save treatment costs and prevent complications caused by blood transfusion.