摘要
目的通过分析自体血回输技术在骨盆骨折手术中的应用情况,为自体血回输技术在临床骨科应用的有效性及安全性提供一定参考。方法通过收集2015年2月至2018年2月期间骨盆骨折术中单纯使用自体血回输或异体血输血的患者,对符合纳入标准患者的基本信息、术中出血量、输血量、血常规、ATP酶活性、TNF-α及C3b,并使用SPSS20.0软件进行统计学分析。结果自体血回输组与异体血输血组均为20例,其中自体血回输组术中出血量为1127.50ml,回输自体血量为464.00ml;异体血输血组术中出血量为745.00ml,异体血输血量为300.00ml。术前自体血回输组的血红蛋白及红细胞比容(Hb:112.80g/L,Hct:32.9%)与异体血输血组(Hb:112.00g/L,Hct:33.4%)比较差异无统计学意义(Hb:P=0.908,Hct:P=0.510);输血后2h及术后第3天两组的血红蛋白及红细胞比容有所下降,但组间比较差异无统计学意义。通过对比自体血回输与异体血输血后发现两组患者在输血后ATP酶活性都有所降低,但是采用自体血回输方法能够抑制ATP酶活性的降低,组间比较发现自体血回输组ATP酶活性明显高于异体血输血组(P=0.002)。输血后两组TNF-α与C3b值都有所升高,输血前后组间比较差异均无统计学意义。结论术中自体血回输可以提高患者红细胞水平,且与异体血回输相比有更高的ATP酶活性,但并不会明显增加机体的炎症反应,是一种值得推广应用的血液管理方法。
Objective In order to analyze the application of intraoperative autologous blood retransfusion in pelvic fracture surgery, providing some effectiveness and safety to the autologous blood transfusion in orthopedic surgery. Methods We carried out a retrospective cross-sectional study in patients undergoing pelvic fracture surgery with intraoperative autologous blood retransfusion and allogeneic blood transfusion. All data were collected from medical records between February 2015 and February 2018.We investigated the basic information, intraoperative blood loss, blood transfusion, blood routine, ATPase activity, TNF-α and C3b from the inclusion criteria. Statistical analysis was performed with SPSS 20.00 software. Results The autologous blood transfusion group and the allogeneic blood transfusion group were all 20 patients, in which the blood loss in the autologous blood transfusion group was 1 127.50 ml and the blood volume returned was 464.00 ml. The blood loss in the allogeneic blood transfusion group was 745.00 ml, and the amount of allogeneic blood transfusion was 300.00 ml. There was no significant difference in autologous blood transfusion group (Hb: 112.80 g/L, Hct: 32.9%) and allogeneic blood transfusion group (Hb:112.00 g/L, Hct:33.4%) before surgery (Hb: P=0.908, Hct: P=0.510). Hemoglobin and hematocrit decreased at 2 hours after transfusion and on the third postoperative day, but there was no significant difference between the two groups. By comparing autologous blood transfusion and allogeneic blood transfusion, it was found that the ATPase activity of both groups was reduced after transfusion, but the autologous blood transfusion method could inhibit the decrease ofATPase activity, and the autologous blood return group was found between groups. ATPase activity was significantly higher than that of allogeneic blood transfusion group (P=0.002). After transfusion, the TNF-α and C3b values were increased in the two groups, but there was no significant difference between the two groups before and after transfusion. Couclusion Intraoperative autologous blood transfusion can improve the patient's red blood cell level, and has higherATPase activity than allogeneic blood transfusion, but it does not significantly increase the body' s inflammatory response. It is a blood management method worthy of popularization and application.
作者
余光书
林焱斌
陈月琴
熊国胜
周家烽
郑伟
Yu Guangshu;Lin Yanbin;Chen Yueqin;Xiong Guosheng;Zhou Jiafeng;ZhengWei(Department of Orthopaedics,Fuzhou Second Hospital Affiliated to Xiamen University,Fuzhou,Fujian,350007,China;Graduate school,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian,350122,China)
出处
《当代医学》
2019年第20期7-10,共4页
Contemporary Medicine
基金
福建省自然科学基金资助项目(2016J01597)
福州市卫生计生科技计划项目(2016-S-wq2)
福州市科技计划项目(2017-S-130-5)
关键词
自体血回输
炎症反应
免疫功能
临床应用
Autologous blood retransfusion
Inflammatory response
Immune function
Clinical application
