使用HDCS-2型血液处理治疗仪进行术中自体血液回收

Intraoperative autotransfusion with HDCS-2 blood recovery-therapy instrument

目的 :评价应用血液处理治疗仪进行术中自体血液回收的临床效果。方法 :2 0 0 0年 8月— 2 0 0 1年 11月使用HDCS 2型血液处理治疗仪在临床外科手术中进行自体血液回收 116例。分析术后血液细胞学指标 ,肝、肾功能指标 ,凝血功能及术后引流情况。结果 :术中血液回收全部成功。处理后的浓缩血其红细胞压积、红细胞计数和血红蛋白含量显著高于回收的原血 ,血小板计数则明显低于回收原血。患者体温变化曲线符合正常术后表现。术后 1d和 1周时红细胞计数、血红蛋白水平、白细胞计数和红细胞压积均明显低于术前 ,而血小板计数虽然在术后1d低于术前 ,但在术后 1周恢复至术前水平。处理后的浓缩血中谷丙转氨酶、谷草转氨酶、总蛋白和尿素氮水平均明显低于回收的原血。术后 1d总蛋白水平低于正常 ,但术后 1周恢复。术后肝、肾功能指标没有明显改变。回收处理过程对肝素的清除率达 (96± 0 .6 ) % ,术后全血激活凝血时间以及术后创面引流量没有明显改变。结论 :使用血液处理治疗仪进行术中自体血液回收可以有效地减少异体血液制品的使用 。

Objective: To evaluation the clinic effects of intraoperative autotransfusion with the blood recovery therapy instrument. Methods: Intraoperative autotransfusion with the blood recovery therapy instrument was performed in 116 operations from Aug 2000 to Nov 2001. The hemocytology, the markers of liver and renal function, blood coagulation and the total amount of drain after operation were analyzed. Results: The autotransfusions were all successful. The levels of HCT, RBC, Hb in processed blood were significantly higher than in the recovered blood, while the PLT was much lower than in the recovered blood. The temperature tendency after intraoperative autotransfusion was in coincidence with the law of reaction after normal operation. The levels of RBC, Hb, WBC and HCT decreased one day and one week after operation compared with those before operation. Although the level of PLT decreased one day after operation, it recovered one week after operation. The levels of ALT, AST, total protein(TP) and BUN were markedly lower in processed blood than in recovered blood. TP was decreased one day after operation, but restored one week after operation. The other markers of liver and renal function did not change during the peri operation. The clearance to heparin of the process was (96±0.6)%. ACT and total amount of drain after operation did not alter obviously. Conclusion: Practice of intraoperative autotransfusion with the blood recovery therapy instrument can reduce the demand of allogenic blood effectually, and the occurrence of complications after operation.