Objective: To explore the blood-saving effect of autologous platelet-rich plasma (PRP) back-transfusion in patients with Stanford type A aortic dissection surgery. Methods: A total of 59 consecutive patients who received Stanford type A aortic dissection surgery in our hospital from 2013-01 to 2015-10 were studied. The patients were at the age of (50±6) years with mean body weighting at (80±12) kg and were randomly divided into 2 groups: Traditional (T) group,n=31 and Autologous PRP back-transfusion (P) group,n=28. Blood levels of Hb, platelet counts, PT, APTT were measured at pre-induction of anesthesia (T1), before CPB (T2), prior ifnishing of CPB (T3) and at 1 h (T4), 24 h (T5), 48 h (T6) after the operation. The in-operative, 48 h post-operative volumes of allogeneic blood transfusion and the volume of chest tube drainage at 48h after operation were recorded; the complication occurrence at peri-operative period was recorded. Results: In P group, whole blood processing volume was (1269±197) ml, PRP volume was (753±78) ml, PRP separation time was (35±9) min and the separated platelets were about (22±3)% of total platelet counts. Compared with T group, P group had decreased Hb at T2 (131.0±15.0) g/L vs (101.0±10.0) g/L, decreased platelet counts at T3 (115.0±51.0)×109 /L vs (83.0±23.0)×109/L, while increased platelet counts at T4 (103.0±25.0)×109/L vs (151.0±27.0)×109/L, T5 (105.0±25.0)×109 /L vs (147.0±39.0)×109/L and T6 (101.0±26.0) ×109/L vs (149.0±35.0)×109/L, allP<0.05; P group presented reduced PT at T4 (17.6±2.1) s vs (14.1±1.1) s and T5 (17.6±2.7) s vs (13.5±0.8) s, allP<0.05. The in-operative transfusions of platelet, plasma, cold precipitation and post-operative transfusions of red blood cells, platelets, plasma, cold precipitation and the volume of chest tube drainage at 48h after operation were less in P group,P<0.05. Compared with T group, P group had the lower rates of acute post-operative lung injury (32.1% vs 19.4%), shorter mechanical ventilation time (69.1±5.9) h vs (43.1±1.5) h and ICU staying time (8.1±2.8) d vs (5.3±1.1) d, allP<0.05. Conclusion: Autologous PRP back-transfusion could reduce the post-operative bleeding and allogeneic blood transfusion for Stanford A aortic dissection surgery, it has obvious blood-saving effect.%目的：探讨术前自体富血小板血浆（PRP）分离回输在A型主动脉夹层手术中的血液保护作用。方法：连续入选2013-01至2015-10期间择期手术的A型主动脉夹层患者59例，平均年龄（50±6）岁，平均体重（80±12）kg。59例患者随机分为两组：传统组（n=31）和自体富血小板血浆分离回输组（回输组，n=28）。分别在麻醉诱导前、心肺转流（CPB）开始前、CPB结束前、术后1 h、24 h、48 h测定血红蛋白（Hb）水平、血小板计数、凝血酶原时间（PT）和活化部分凝血酶时间（APTT）。记录术中和术后48 h异体输血情况和术后48 h引流量。记录围术期并发症发生情况。结果：回输组PRP分离处理的全血容量（1269±197）ml，PRP容量（753±78）ml，PRP分离时间（35±9）min，分离血小板数量占全身总数的（22±3）%。与传统组比较，回输组血红蛋白水平CPB开始前明显降低[（131.0±15.0） g/L vs（101.0±10.0）g/L，P<0.05]，血小板计数在CPB结束前明显减少[（115.0±51.0）×109/L vs （83.0±23.0）×109/L， P<0.05]，在术后1 h、24 h、48 h明显增加[（103.0±25.0）×109/L vs （151.0±27.0）×109/L、（105.0±25.0）×109/L vs （147.0±39.0）×109/L、（101.0±26.0）×109/L vs （149.0±35.0）×109/L，P均<0.05]，PT和APTT在术后1 h、24 h明显缩短[（17.6±2.1）s vs （14.1±1.1）s、（17.6±2.7）s vs（13.5±0.8）s，P均<0.05]。回输组术中血小板、血浆和冷沉淀输入量和术后红细胞、血小板、血浆和冷沉淀输入量及术后48 h引流量显著少于传统组（P<0.05）。与传统组比较，回输组术后急性肺损伤明显减少（32.1% vs19.4%，P<0.05），机械通气时间和重症监护病房（ICU）停留时间明显缩短[（69.1±5.9）h vs （43.1±1.5）h、（8.1±2.8） d vs （5.3±1.1）d，P<0.05]。结论：术前自体富血小板血浆分离回输能显著减少A型主动脉夹层术后出血量和异体输血量，具有明显的血液保护作用。
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