目的观察术中自体血回输量对患者凝血功能的影响。方法选取进行手术的129例患者,根据术中出血量及回输血量的多少将129例患者分为A组(43例)、B组(43例)、C组(43例),对比3组凝血功能。结果随回输血量的增加,3组患者的PT指标分别从(12.6&#...目的观察术中自体血回输量对患者凝血功能的影响。方法选取进行手术的129例患者,根据术中出血量及回输血量的多少将129例患者分为A组(43例)、B组(43例)、C组(43例),对比3组凝血功能。结果随回输血量的增加,3组患者的PT指标分别从(12.6±1.8)s,(13.4±1.6)s,(12.3±1.7)s,增加到(13.5±2.3)s,(15.4±1.7)s,(17.3±1.9)s;3组患者的APTT指标分别从(30.4±4.3)s,(33.2±4.1)s,(32.7±4.5)s,增加到(33.6±4.8)s,(35.4±3.9)s,(40.3±4.6)s;3组患者的TT指标分别从(15.6±2.8)s,(16.9±2.3)s,(16.1±2.5)s增加到(17.1±2.4)s,(16.6±2.5)s,(17.0±2.7)s;3组患者的FIB指标从(3.1±0.7)g/L,(1.9±0.6)g/L,(2.6±0.4)g/L,减少到(2.8±0.4)g/L,(1.9±0.3)g/L,(1.5±0.6)g/L,差异均有统计学意义(P<0.05)。结论总出血量在2 500 m L以下、回输自体红细胞<1 000 m L时不补充凝血因子对凝血功能无影响的,当总出血量>2 500 m L以上、回输自体红细胞>1 000 m L要适当补充凝血因子。展开更多
The safe use of intraoperative blood salvage （IBS） in cancer surgery remains controversial. Here, we investigated the kil ing effect of cisplatin combined with hyperthermia on human hepatocarcinoma （HepG2） cel s a...The safe use of intraoperative blood salvage （IBS） in cancer surgery remains controversial. Here, we investigated the kil ing effect of cisplatin combined with hyperthermia on human hepatocarcinoma （HepG2） cel s and erythrocytes from IBS in vitro. HepG2 cel s were mixed with concentrated erythrocytes and pretreated with cisplatin （50, 100, and 200μg/ml） alone at 37 °C for 60 min and cisplatin （25, 50, 100, and 200μg/ml） combined with hyperthermia at 42 °C for 60 min. After pretreatment, the cel viability, colony formation and DNA metabolism in HepG2 and the Na＋-K＋-ATPase activity, 2,3-diphosphoglycerate （2,3-DPG） concentration, free hemoglobin （Hb） level, osmotic fragility, membrane phosphatidylserine externalization, and blood gas variables in erythrocytes were determined. Pretreatment with cisplatin （50, 100, and 200μg/ml） combined with hyperthermia （42 °C） for 60 min significantly decreased HepG2 cel viability, and completely inhibited colony formation and DNA metabolism when the HepG2 cel concentration was 5×104 ml？1 in the erythrocyte （P0.05）. In conclusion, pre-treatment with cisplatin （50μg/ml） combined with hyperthermia （42 °C） for 60 min effectively eliminated HepG2 cel s from IBS but did not significantly affect erythrocytes in vitro.展开更多
文摘目的观察术中自体血回输量对患者凝血功能的影响。方法选取进行手术的129例患者,根据术中出血量及回输血量的多少将129例患者分为A组(43例)、B组(43例)、C组(43例),对比3组凝血功能。结果随回输血量的增加,3组患者的PT指标分别从(12.6±1.8)s,(13.4±1.6)s,(12.3±1.7)s,增加到(13.5±2.3)s,(15.4±1.7)s,(17.3±1.9)s;3组患者的APTT指标分别从(30.4±4.3)s,(33.2±4.1)s,(32.7±4.5)s,增加到(33.6±4.8)s,(35.4±3.9)s,(40.3±4.6)s;3组患者的TT指标分别从(15.6±2.8)s,(16.9±2.3)s,(16.1±2.5)s增加到(17.1±2.4)s,(16.6±2.5)s,(17.0±2.7)s;3组患者的FIB指标从(3.1±0.7)g/L,(1.9±0.6)g/L,(2.6±0.4)g/L,减少到(2.8±0.4)g/L,(1.9±0.3)g/L,(1.5±0.6)g/L,差异均有统计学意义(P<0.05)。结论总出血量在2 500 m L以下、回输自体红细胞<1 000 m L时不补充凝血因子对凝血功能无影响的,当总出血量>2 500 m L以上、回输自体红细胞>1 000 m L要适当补充凝血因子。
基金Project supported by the Scientific Research from Chinese Ministryof Health-Zhejiang Health Department,China(Nos.WKJ2008-2-021and WKJ2013-2-019)
文摘The safe use of intraoperative blood salvage （IBS） in cancer surgery remains controversial. Here, we investigated the kil ing effect of cisplatin combined with hyperthermia on human hepatocarcinoma （HepG2） cel s and erythrocytes from IBS in vitro. HepG2 cel s were mixed with concentrated erythrocytes and pretreated with cisplatin （50, 100, and 200μg/ml） alone at 37 °C for 60 min and cisplatin （25, 50, 100, and 200μg/ml） combined with hyperthermia at 42 °C for 60 min. After pretreatment, the cel viability, colony formation and DNA metabolism in HepG2 and the Na＋-K＋-ATPase activity, 2,3-diphosphoglycerate （2,3-DPG） concentration, free hemoglobin （Hb） level, osmotic fragility, membrane phosphatidylserine externalization, and blood gas variables in erythrocytes were determined. Pretreatment with cisplatin （50, 100, and 200μg/ml） combined with hyperthermia （42 °C） for 60 min significantly decreased HepG2 cel viability, and completely inhibited colony formation and DNA metabolism when the HepG2 cel concentration was 5×104 ml？1 in the erythrocyte （P0.05）. In conclusion, pre-treatment with cisplatin （50μg/ml） combined with hyperthermia （42 °C） for 60 min effectively eliminated HepG2 cel s from IBS but did not significantly affect erythrocytes in vitro.
